Abstract: Pediatric POCUS: Skull Fractures Detection

using POCUS to diagnose emergency child head trauma

The utility of Ultrasound in detecting skull fractures after pediatric blunt head trauma. Systematic review and meta-analysis.

Source: Pediatr Emer Care 2020; Feb 28


The evaluation for traumatic brain injury typically involves computed tomography, which exposes children to ionizing radiation. However, POCUS can be used to diagnose skull fractures.

This systematic review/meta-analysis was done to determine operating characteristics of POCUS skull studies in the diagnosis of fractures in pediatric head trauma patients.

Six studies of 393 patients were selected. The pooled sensitivity of 91% and specificity of 96% resulted in pooled positive likelihood ratio of 14.4 and negative likelihood ratio of 0.14.

The author concluded that a POCUS skull study significantly increases the probability of skull fracture, whereas a negative study markedly decreases the probability if the pretest probability is very low.