Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Feb;53(2):307-318.
doi: 10.1007/s00256-023-04396-3. Epub 2023 Jul 12.

A systematic review and meta-analysis on the diagnostic utility of ultrasound for clavicle fractures

Amir Hassankhani  1   2 , Melika Amoukhteh  3   4 , Payam Jannatdoust  3 , Parya Valizadeh  3 , Ali Gholamrezanezhad  3
Affiliations
Meta-Analysis

A systematic review and meta-analysis on the diagnostic utility of ultrasound for clavicle fractures

Amir Hassankhani et al. Skeletal Radiol. 2024 Feb.

Abstract

Background: Ultrasound's real-time, high-resolution imaging, and accessibility at the point of care make it a valuable tool for diagnosing clavicle fractures, with growing evidence supporting its diagnostic accuracy compared to other imaging modalities.

Objective: To assess the diagnostic utility of ultrasound in detecting clavicle fractures.

Methods: A systematic review and meta-analysis were conducted by performing a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases up to March 10, 2023, following established guidelines. Eligible studies that reported outcomes of interest were included, relevant data elements were extracted, and data analysis was performed using STATA software version 17.0.

Results: Meta-analysis of seven included studies showed high-pooled sensitivity (0.94) and specificity (0.98) values for ultrasonography in diagnosing clavicle fractures, with low to moderate heterogeneity for sensitivity and high heterogeneity for specificity. Meta-regression and subgroup analyses revealed that pediatric studies had higher sensitivity but significantly lower specificity (P=0.01) compared to mixed or adult studies. Additional subgroup analysis in the pediatric group indicated decreased heterogeneity for specificity. Fagan plot analysis demonstrated favorable post-test probabilities for both positive and negative results across varying pre-test probabilities. Additionally, the likelihood ratio scatter matrix showed moderate to high test performance for both exclusion and confirmation purposes.

Conclusion: The current literature supports ultrasound as a reliable imaging modality for detecting clavicle fractures. It offers accurate diagnosis without exposing patients, especially children, to radiation.

Keywords: Clavicle fracture; Diagnosis; Ultrasound.

PubMed Disclaimer

References

    1. Nicholson JA, Tsang STJ, MacGillivray TJ, Perks F, Simpson AHRW. What is the role of ultrasound in fracture management?: diagnosis and therapeutic potential for fractures, delayed unions, and fracture-related infection. Bone Joint Res. 2019;8(7):304–12. - DOI - PubMed - PMC
    1. Ackermann O, Simanowski J, Eckert K. Fracture ultrasound of the extremities. Ultraschall Med. 2020;41(1):12–28. - DOI - PubMed
    1. Du MJ, Lin YH, Chen WT, Zhao H. Advances in the application of ultrasound for fracture diagnosis and treatment. Eur Rev Med Pharmacol Sci. 2022;26(21):7949–54. - PubMed
    1. Chiu YH, Shyu SG. Utilization of diagnostic ultrasound in the detection of hip fracture. Med Ultrason. 2021;23(2):240–1. - PubMed
    1. Litrenta J, Masrouha K, Wasterlain A, Castaneda P. Ultrasound evaluation of pediatric orthopaedic patients. J Am Acad Orthop Surg. 2020;28(16):e696–705. - DOI - PubMed

LinkOut - more resources