The utility of bedside ultrasound and patient perception in detecting soft tissue foreign bodies in children.

OBJECTIVE

The purpose of the study was to determine if bedside ultrasound (US) and perception of wound foreign bodies (FBs) are useful screening tools for detecting wound FBs in children.

METHODS

Prospective consecutive sample of children aged 18 years or younger presenting to a pediatric emergency department with wounds considered by the pediatric emergency department attending physician to be at risk for FBs was enrolled. Patients were asked if they had FB sensation in their wound(s). A bedside US of each wound was performed by the pediatric emergency department attending physician. A radiograph of each wound was obtained and interpreted by a radiologist blinded to US results and patient perception. Wound FBs were defined by the removal of a FB. The utilities of US and US with FB perception were compared with radiography for screening for wound FBs. Differences in performance characteristics among the 3 modalities were assessed using Fisher exact test.

RESULTS

One hundred thirty-one wounds were studied in 105 patients. FBs were identified in 12 wounds (9.2%). A subanalysis was performed on patients able to answer questions regarding their perception of wound FBs. There were no significant differences in the test performance characteristics of bedside US alone compared with radiography for detecting wound FBs. Except for specificity, there were no significant differences in the test performance characteristics of bedside US combined with perception compared with radiography for detecting wound FBs.

CONCLUSIONS

Bedside US is comparable to the performance of radiography interpreted by an attending pediatric radiologist. Bedside US alone or combined with patient perception may be an adequate initial screening tool for detecting wound FBs.