Iranian Journal of Orthopedic Surgery

Abstract Introduction: Elbow fractures are common in both pediatric and adult populations, and accurate diagnosis is crucial for proper treatment. While radiography is the standard method, alternative imaging techniques such as ultrasound are increasingly explored, especially when radiographic imaging is not ideal. This study evaluated the diagnostic accuracy of ultrasound in detecting elbow fractures, comparing it with radiography and computed tomography (CT) as reference standards.
Materials & Methods: Forty patients with suspected elbow fractures underwent imaging using ultrasound, radiography, and CT. Results from all three methods were compared to assess sensitivity, specificity, and agreement between ultrasound and the reference standards.
Results & Discussion: The mean patient age was 15.5 years (range: 4–49), with 72.5% male (n=29). Supracondylar fractures were most common in patients under 18, while radial head fractures predominated in those over 18. Ultrasound showed good diagnostic performance, with 88.9% sensitivity, 87% specificity, and a kappa value of 0.73 compared to radiography. Against CT, ultrasound demonstrated 94.8% sensitivity and 89.7% specificity.
Conclusion: Ultrasound is an accurate, non-invasive, and cost-effective alternative to radiography and CT for diagnosing elbow fractures, especially in emergency or resource-limited settings. Its strong diagnostic performance, particularly in children, supports its use as a reliable tool. Further studies with larger samples and follow-up are recommended.