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==Background==
*U/S can be used to find fractures with high specificity and sensitivity
*U/S is an added option for post-reduction if fluoro is not available

==Sensitivity and Specificity==
*Fifth metatarsal fracture - SN 0.971 and SP 1.00<ref>Ha AS, et al. The accuracy of bedside ultrasonography as a diagnostic tool for the fifth metatarsal fractures. The American journal of emergency medicine (Impact Factor: 1.54). 11/2013; DOI: 10.1016/j.ajem.2013.11.00</ref>
*Long bone fracture - SN 0.929 and SP 0.833 (vs PE which is 0.786 and 0.90)<ref>Marshburn, TH, et al. Goal-Directed Ultrasound in the Detection of Long-Bone Fractures. Journal of Trauma-Injury Infection & Critical Care. 2004; 57(2):329-332. doi:10.1097/01.TA.0000088005.35520.CB </ref>
*Rib fracture - SN 0.90 and SP 1.00 (vs CXR with is 0.15 and 1.00)<ref>Griffith, JF, et al. Sonography compared with radiography in revealing acute rib fracture. American Journal of Roentgenology. 1999;173: 1603-1609.</ref>
*Pediatric Long Bone: SN 0.953 and 0.855<ref>Barata I1 et al. Emergency ultrasound in the detection of pediatric long-bone fractures. Pediatr Emerg Care. 2012 Nov;28(11):1154-7. doi: 10.1097/PEC.0b013e3182716fb7.</ref>
**Ultrasound detected 100.0% of diaphyseal fractures and 93.1% of end-of-bone or near-joint fractures

==Images==
===Normal===
<gallery>
File:Long Access Bone.jpg|Longitudinal view of long bone
File:Longitudinal Bone Probe.jpg|Longitudinal view
File:Short Access Bone.jpg|Transverse view of long bone
File:Short Bone Probe.jpg|Transverse view
</gallery>

===Abnormal===
<gallery>
File:Generic fracture.png|Fracture
File:Intertroch fracture.png|Intertrochanteric Fracture
File:Metacarpal fracture.png|Metacarpal Fracture
</gallery>

==Instructions==
#Use linear probe (high frequency probe)
#Place probe in longitudinal plane with bone over site of deformity or maximal pain
#Fan and slide side to side to optimize
#Slide distal to proximal to find tranverse and oblique fractures
#Turn probe 90° to assess for longitudinal and oblique fractures

==Findings==
*Positive Findings
**Discontinuity in the cortex of the bone
**Hypoechoic fluid collection over the cortex can suggest a hematoma and suggests a fracture could be present
*Negative Findings
**Continuous cortex

==Pearls and Pitfalls==
*As you enter the joint, there can be discontinuity in the bones but not sharp or abruptly
*A similar discontinuity can be seen over growth plates, but again are not abrupt
*A water bath may aid in searching for fractures in the hands and feet

==See Also==
*[[Ultrasound: MSK]]
*[[Ultrasound: Joint]]


==External Links==

==References==
<references/>

[[Category:Radiology]]
[[Category:Orthopedics]]