COSTO-CHONDRAL JUNCTION FRACTURE
Findings : Costo-chondral junction fracture.
Costo-chondral junction fracture :
This injuries occur in the cartilage connecting the ribs anteriorly to the sternum.
Ultrasound can directly show the costal cartilage that is occult on chest radiography and therefore can be used to evaluate for costochondral abnormalities when chest radiography is negative
In USG, discontinuity of cortical alignment and an acoustic linear edge shadow are two diagnostic criteria for detection of fractured rib. In blunt chest trauma patients, USG can quickly confirm or rule out associated findings such as pleural effusion, pneumothorax and hemothorax.1
Ultrasound findings :
Presence of fracture line, disruption of the anterior echogenic margin, a step-off deformity, or gas located at the costochondral junction.
Ultrasound also has the advantage of being a dynamic examination that can detect abnormal movement at the fracture site and avoid exposure to X-ray radiation.
Pitfalls include:
- confusion of the pleural surface with rib cortex
- misinterpretation as a fracture due to:
o transducer overlying a rib and either an intercostal space or scapula
o costal cartilage calcifications parallel to the rib surface (less likely in the paediatric population)
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