Ultrasound should not be used for fractures at which sites?

Ultrasound should not be used for fractures at which sites?

• A. Skull and open epiphysis
• B. Long bones
• C. Pelvis
• D. Ribs

Answer: (A)

Ultrasound is not reliable for imaging fractures in areas where bone is highly ossified or where the fracture involves cartilaginous tissue. The skull is densely mineralized, and sound waves don’t penetrate to reveal fracture lines effectively, leading to missed fractures and poor diagnostic value. In children, the growth plates (open epiphyses) are largely cartilage, and a fracture through or near these physes can be occult on ultrasound; plain radiographs are the standard way to assess physeal injuries because they clearly show the integrity and alignment of the growth plate and the adjacent bone. For other sites like long bones, the pelvis, or ribs, ultrasound can provide useful information in some contexts, but it is not the primary modality for fracture assessment there either; radiographs (and CT or MRI when needed) remain the gold standard.

Ultrasound is not reliable for imaging fractures in areas where bone is highly ossified or where the fracture involves cartilaginous tissue. The skull is densely mineralized, and sound waves don’t penetrate to reveal fracture lines effectively, leading to missed fractures and poor diagnostic value. In children, the growth plates (open epiphyses) are largely cartilage, and a fracture through or near these physes can be occult on ultrasound; plain radiographs are the standard way to assess physeal injuries because they clearly show the integrity and alignment of the growth plate and the adjacent bone.

For other sites like long bones, the pelvis, or ribs, ultrasound can provide useful information in some contexts, but it is not the primary modality for fracture assessment there either; radiographs (and CT or MRI when needed) remain the gold standard.