Xray or Ultrasound for soft tissue foreign bodies
Date First Published:
February 1, 2007
Last Updated:
May 14, 2007
Report by:
Jacqueline du Toit, Paediatric A+E RMO (St Mary's Hospital)
Three-Part Question:
In [a child with a soft tissue foreign body], is [ultrasound better than xray] at [detection of the foreign body]?
Clinical Scenario:
A 6-year-old girl presents to the emergency department with complaints of a painful foot, and the history of having stepped on an unknown foreign body. You wonder whether an x-ray or ultrasound would be better at detecting this.
Search Strategy:
Medline 1950-02/07
Search Details:
SOFT ADJ TISSUE AND FOREIGN ADJ BODY AND ULTRASOUND AND (CHILD# OR ADOLESCENT.DE. OR INFANT#) AND LG=EN
Outcome:
22 papers were found, of which 21 were irrelevant or of insufficient quality. The remaining paper is shown in the table below.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| The Utility of Bedside Ultrasound and Patient Perception in Detecting Soft Tissue Foreign Bodies in Children. Friedman DI, Forti RJ, Wall SP, Crain EF. 2004 US | 105 children with a suspected retained FB | Prospective diagnostic cohort | Foreign body detected and recovered | 12 foreign bodies identified. | 12 foreign bodies identified. US detected 8 of 12, and x-ray 7 of 12 cases. |
Author Commentary:
Bedside US technique and interpretation has potential limitations with differences in US expertise among physicians.
Bottom Line:
Bedside US is comparable to radiography, and may be an ideal ED screening tool in the detection of soft tissue FBs in children.
References:
- Friedman DI, Forti RJ, Wall SP, Crain EF.. The Utility of Bedside Ultrasound and Patient Perception in Detecting Soft Tissue Foreign Bodies in Children.