Bedside Ultrasound in the Diagnosis of Ankle Fractures in Children

Objectives:

A lot of children who injure their ankles come to the emergency department for an
evaluation, and often an X-ray of the ankle is obtained to determine if a bone fracture is
present. In more than 85% of cases, however, the injury is a sprain and not a bone fracture
and can be treated with rest, ice, elevation, and pain medications. X-rays obtained in the
emergency departments are time consuming, often uncomfortable for the patient, and expose
children to radiation, the long-term effects of which are not yet fully understand by
doctors or scientists. Bedside ultrasound is a non-invasive and a non-painful device that
does not produce radiation. It was been shown to determine the presence of bone fracture in
childrens' wrists and forearms just as well as X-rays do. In our study, the investigators
would like to determine if a bedside ultrasound can also be used to evaluate ankle fractures
in children.

Research Procedures:

In our study, the investigators will ask the parents and children, who are scheduled to get
an X-ray of their ankle in the emergency department, to examine their ankles with an
ultrasound machine as well. Since the bedside ultrasound is not significantly
time-consuming, does not require patients to remain still, and is readily available in the
department, the procedure will be performed while kids are waiting to get an X-ray, getting
registered, or awaiting further treatment. On the data collection form, the investigators
will document the patients' names, birthdates, medical record numbers so that their X-ray
results can be compared to the ultrasound results for the purpose of the study. The
information will be stored in a secure cabinet in a locked office. The investigators will
also document which side is injured, where the patient feels pain and what the ankle looks
like to help perform the ultrasound. The results of both the ultrasound and X-ray will be
documented for each patient.