Double line sign: a helpful sonographic sign to detect occult fractures of the proximal humerus.

Abstract:

:The aim of this study was to describe a new sonographic sign of bone fracture and to determine if it can be helpful in decreasing the number of missed fractures of the proximal humerus. Ultrasound (US) of the shoulder was performed in 57 consecutive patients with shoulder pain and/or disability following trauma. All cases were prospectively reviewed for the presence of a humeral fracture. Sonographic signs of fractures, with special emphasis on what was termed the 'double line sign' (DLS), were assessed. Plain radiography was considered the standard of reference and in equivocal cases magnetic resonance imaging (MRI). Twenty-eight patients had a tuberosity complex fracture, which were all detected at US examination. Sonographic features of a fracture were periosteal elevation, corticol bone discontinuity, step-off deformity or a combination of these findings. This study showed that in 26 (93%) patients an additional sonographic feature, a DLS, could be demonstrated. The DLS is a helpful and probably reliable sonographic sign to indicate a humeral fracture. High-spatial-resolution US substantially increases the detection of fractures of the proximal humerus and should be considered as an alternative diagnostic tool prior to computed tomography (CT), MRI and arthroscopy in patients with persisting shoulder pain and/or disability following trauma.

journal_name

Eur Radiol

journal_title

European radiology

authors

Rutten MJ,Jager GJ,de Waal Malefijt MC,Blickman JG

doi

10.1007/s00330-006-0331-1

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

762-7

issue

3

eissn

0938-7994

issn

1432-1084

journal_volume

17

pub_type

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