Diagnostic Accuracy of Ultrasound in Detecting Elbow Fractures: A Comparison with Radiography and CT Scans

Soltani, Fakhreddin; Ghane, Mohammad Reza; Alimohamadi, Yousef; Jafari, Ramezan; Ghazale, Amir Hosein; Abbaszadeh, Mahdi; Behzadnia, Mohammad Javad

doi:10.22034/ijos.2025.545680.1147

Diagnostic Accuracy of Ultrasound in Detecting Elbow Fractures: A Comparison with Radiography and CT Scans

Document Type : Original Article

Authors

Fakhreddin Soltani ¹ ^¶

Mohammad Reza Ghane ¹

Yousef Alimohamadi ²

Ramezan Jafari ²

Amir Hosein Ghazale ³

Mahdi Abbaszadeh ³

Mohammad Javad Behzadnia ⁴

¹ Department of Emergency Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.

² Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

³ Department of Orthopedic Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.

⁴ Department of Emergency Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

https://doi.org/10.22034/ijos.2025.545680.1147

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.

Keywords

Elbow fractures, Ultrasonography, Computed X ray tomography, Radiography

Subjects