Sternal Fracture Complicated by a Subcutaneous Abscess in a 5-Year-Old Boy and Diagnosed Using Point-of-Care Ultrasound.
abscess
child
point-of-care ultrasound
sternal fracture
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
17
09
2018
revised:
12
12
2018
accepted:
24
12
2018
pubmed:
13
2
2019
medline:
19
9
2019
entrez:
13
2
2019
Statut:
ppublish
Résumé
Although fractures of the sternum are rare in young children, owing to the compliance of the chest wall, these fractures are still possible and require thorough examination. We present a case that emphasizes the usefulness of point-of-care ultrasound in the diagnosis of a pediatric sternal fracture complicated by a subcutaneous abscess. A 5-year-old boy presented with tenderness of the sternum, with diffuse swelling extending bilaterally to the anterior chest wall. Ultrasound imaging identified irregular alignment of the sternum with a subcutaneous abscess and swirling of purulent material within the abscess in the fracture area. These findings were confirmed on enhanced chest computed tomography and had not been visible at the time of the first evaluation 6 days prior. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Our case demonstrates the usefulness of point-of-care ultrasound for the diagnosis and appropriate management of a sternal fracture complicated by a subcutaneous abscess in a young child. As ultrasound imaging is easy to perform at the bedside, it is useful for examining pediatric patients with swelling of the anterior chest and local tenderness of the sternum to rule out a sternal fracture, even if these fractures are deemed to be uncommon in children.
Sections du résumé
BACKGROUND
BACKGROUND
Although fractures of the sternum are rare in young children, owing to the compliance of the chest wall, these fractures are still possible and require thorough examination. We present a case that emphasizes the usefulness of point-of-care ultrasound in the diagnosis of a pediatric sternal fracture complicated by a subcutaneous abscess.
CASE REPORT
METHODS
A 5-year-old boy presented with tenderness of the sternum, with diffuse swelling extending bilaterally to the anterior chest wall. Ultrasound imaging identified irregular alignment of the sternum with a subcutaneous abscess and swirling of purulent material within the abscess in the fracture area. These findings were confirmed on enhanced chest computed tomography and had not been visible at the time of the first evaluation 6 days prior. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Our case demonstrates the usefulness of point-of-care ultrasound for the diagnosis and appropriate management of a sternal fracture complicated by a subcutaneous abscess in a young child. As ultrasound imaging is easy to perform at the bedside, it is useful for examining pediatric patients with swelling of the anterior chest and local tenderness of the sternum to rule out a sternal fracture, even if these fractures are deemed to be uncommon in children.
Identifiants
pubmed: 30745197
pii: S0736-4679(18)31233-2
doi: 10.1016/j.jemermed.2018.12.040
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
536-539Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.