Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of Nasal Bone Fractures

Abstract

Background/objective: We evaluated the diagnostic accuracy of ultrasonography and conventional radiography compared to clinical examination as the gold-standard technique to determine whether ultrasonography can be the primary diagnostic method for the evaluation of nasal bone fracture. Patients and Methods: The conventional Waters and lateral nasal bone view radiography and high resolution ultrasonography of 171 patients (128 men, 43 women; mean+/-SD age, 24+/-8 years) with a clinical or forensic indication for the evaluation of nasal bone fracture were investigated. The negative likelihood ratio (LR-), positive likelihood ratio (LR+), specificity (Sp) and sensitivity (Se) were used for determining the diagnostic accuracy. The negative predictive value (NPV) and the positive predictive value (PPV) were also determined. Results: Of 103 fracture lines in patients with a clinically diagnosed nasal bone fracture, conventional radiography detected 80, while ultrasonography detected 90 fractures. The Se of ultrasonography and conventional radiography was 90.2% and 77.6%, respectively; the Sp was 98.5% and 82%, respectively. Conclusion: High-resolution ultrasonography can be used as an accurate technique for evaluating nasal bone fracture. Conventional radiography can be replaced by hiqh-resolution ultrasonograhy.