Abstract
Objective: The aims of this study were to examine the ultrasound images of normal ribs and rib fractures, present an examination checkpoint, and propose a new representation and scanning method for rib lesion sites. Subjects and methods: Forty-four patients (24 men, 20 women) with an average age of 64 years (range, 24- 84 years) were selected from a group of 83 patients who underwent diagnostic ultrasound for suspected rib fractures over a period of 54 months from August 2006 to February 2011. The following points were investigated: (1) Body position of subject and scanning methods, (2) Ultrasound images of healthy ribs, (3) Images resembling fractures, (4) Checkpoints based on rib fracture ultrasound findings, and (5) Proposal of a new representation of lesion sites. Results: The subjects underwent ultrasound diagnosis in the oblique or lateral recumbent position. Depending on the scanning method used, healthy ribs and costal cartilages had different appearances on ultrasound images and were confused with fractures. Ultrasound findings indicating rib fractures were mostly cortical step-offs (step sign) and hematomas on the surface of the bone, consistent with the location of tenderness. Fracture sites were displayed using the clock method, which allowed retroactive and objective display. Conclusions: Ultrasound examination of ribs was performed by scanning locations of tenderness using a linear transducer to produce enlarged images. Both step signs and echo-free spaces on the bone surface were scanned. Ultrasound examination of rib fractures was easy to perform and effective as a diagnostic tool. It is preferred in suspected rib fracture cases.
