Sonography compared with radiography in revealing acute rib fracture

OBJECTIVE. This study was undertaken to compare the sensitivities of sonogr aphy and radiography for revealing acute rib fracture. SUBJECTS AND METHODS. Chest radiography and rib sonography were performed o n 50 patients with suspected rib fractures. Sonography was performed with a 9- or 12-MHz linear transducer. Fractures were identified by a disruption of the anterior margin of the rib, costochondral junction, or costal cartil age. The incidence, location, and degree of displacement of fractures revea led by radiography and sonography were compared. Sonography was performed a gain after 3 weeks in 37 subjects. RESULTS. At presentation, radiographs revealed eight rib fractures in six ( 12%) of 50 patients and sonography revealed 83 rib fractures in 39 (78%) of 50 patients. Seventy-four (89%) of the 83 sonographically detected fractur es were located in the rib, four (5%) were located at the costochondral jun ction, and five (6%) in the costal cartilage. Repeated sonography after 3 w eeks showed evidence of healing in all reexamined fractures. Combining sono graphy at presentation and after 3 weeks, 88% of subjects had sustained a f racture. CONCLUSION. Sonography reveals more fractures than does radiography and wil l reveal fractures in most patients presenting with suspected rib fracture. Further scientific studies are needed to clarify the appropriate role for sonography in rib fracture detection.