Diagnostic accuracy of point-of-care ultrasonography in physeal fractures

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dc.contributor.authorGurkan, Onur
dc.contributor.authorKozaci, Nalan
dc.contributor.authorColak, Songul
dc.contributor.authorAydin, Ismail Erkan
dc.date.accessioned2026-01-24T12:31:04Z
dc.date.available2026-01-24T12:31:04Z
dc.date.issued2026
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractObjective: The aim of this study was to compare the accuracy of Point of Care Ultrasound (POCUS) with X-ray (XR) in the diagnosis of physeal fractures and Salter-Harris classification in pediatric patients. Methods: The study was conducted in a university hospital emergency department between January 1, 2024 and June 30, 2025. Pediatric patients aged 0-18 years who were admitted to the emergency department due to extremity trauma, had stable vital signs, and presented with suspected physeal fractures on physical examination were included in this prospective study. Results: A total of 117 patients were included in the study. Fractures were detected on XR in 73 % of patients. Compared with XR, POCUS demonstrated a sensitivity (Sn) of 97 %, specificity (Sp) of 94 %, positive predictive value (PPV) of 98 %, negative predictive value (NPV) of 91 % (AUC: 0.951, 95 % CI: 0.90-1.00), and a kappa value of 0.894 for fracture detection. For physeal fractures, POCUS showed Sn 93 %, Sp 95 %, PPV 74 %, NPV 99 % (AUC: 0.942, 95 % CI: 0.87-1.00) and kappa = 0.794. For detecting the extension of the fracture into the joint space, POCUS showed Sn 62 %, Sp 100 %, PPV 54 %, NPV 100 % (AUC: 0.810; 95 % CI: 0.68-0.94) and a kappa value of 0.727. Moderate concordance was observed between POCUS and XR for Salter-Harris classification (kappa = 0.673). Conclusion: POCUS demonstrates high sensitivity in detecting traumatic extremity fractures and physeal fractures in pediatric patients. However, only moderate concordance was observed between POCUS and XR in assessing the extension of the fracture into the joint space and in applying the Salter-Harris classification. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
dc.identifier.doi10.1016/j.ajem.2025.12.009
dc.identifier.endpage204
dc.identifier.issn0735-6757
dc.identifier.issn1532-8171
dc.identifier.pmid41418495
dc.identifier.scopus2-s2.0-105024849134
dc.identifier.scopusqualityQ1
dc.identifier.startpage198
dc.identifier.urihttps://doi.org/10.1016/j.ajem.2025.12.009
dc.identifier.urihttps://hdl.handle.net/20.500.12868/5630
dc.identifier.volume100
dc.identifier.wosWOS:001647864300001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherW B Saunders Co-Elsevier Inc
dc.relation.ispartofAmerican Journal of Emergency Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20260121
dc.subjectPediatric extremity trauma
dc.subjectPhyseal fracture
dc.subjectPOCUS
dc.subjectSalter-Harris classification
dc.subjectX-ray
dc.titleDiagnostic accuracy of point-of-care ultrasonography in physeal fractures
dc.typeArticle

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