Comparison of ultrasonography and conventional radiography in the diagnosis of nasal bone fractures

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 high-resolution ultrasonograhy.