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Assessment of the usefulness of ultrasound in the diagnosis of skull fractures in children – a five-year institutional experience Cover

Assessment of the usefulness of ultrasound in the diagnosis of skull fractures in children – a five-year institutional experience

Open Access
|Dec 2025

Figures & Tables

Fig. 1.

Normal cranial sutures in (A) a 4-month-old and (B) a 6-month-old boy, which may mimic a fracture line. The overlying soft tissues show normal echostructure above the suture line
Normal cranial sutures in (A) a 4-month-old and (B) a 6-month-old boy, which may mimic a fracture line. The overlying soft tissues show normal echostructure above the suture line

Fig. 2.

Examples of skull fracture fissures observed on ultrasound in (A) a 2-month-old boy and (B) a 1-month-old girl. A. Fracture fissure of the parietal bone with an associated subperiosteal hematoma (calipers). B. Fracture fissure of the parietal bone with a 1-mm cortical invagination (calipers)
Examples of skull fracture fissures observed on ultrasound in (A) a 2-month-old boy and (B) a 1-month-old girl. A. Fracture fissure of the parietal bone with an associated subperiosteal hematoma (calipers). B. Fracture fissure of the parietal bone with a 1-mm cortical invagination (calipers)

Fig. 3.

Left parietal bone fracture. A. Ultrasound examination revealed a subtle cortical discontinuity and deflection of the outer table. B. A subperiosteal hematoma was visible along the parietal bone. C, D. CT examination performed the following day confirmed the diagnosis, demonstrating a linear fracture fissure (arrow in C) of the parietal bone
Left parietal bone fracture. A. Ultrasound examination revealed a subtle cortical discontinuity and deflection of the outer table. B. A subperiosteal hematoma was visible along the parietal bone. C, D. CT examination performed the following day confirmed the diagnosis, demonstrating a linear fracture fissure (arrow in C) of the parietal bone

Fig. 4.

Comminuted fracture of the frontal bone involving the superior and superolateral wall of the right orbit. A. Ultrasound examination showed a displaced fracture in the region of the right supraorbital arch, with (B) a 4-mm cortical invagination (calipers). C, D. CT examination confirmed a comminuted fracture of the superior and superolateral orbital wall
Comminuted fracture of the frontal bone involving the superior and superolateral wall of the right orbit. A. Ultrasound examination showed a displaced fracture in the region of the right supraorbital arch, with (B) a 4-mm cortical invagination (calipers). C, D. CT examination confirmed a comminuted fracture of the superior and superolateral orbital wall

Diagnostic performance of ultrasound across multiple studies

Study (first author, year)Sample size (n)Age group (median/mean age)Sensitivity (%) [95% CI]Specificity (%) [95% CI]Study design
Current study (2025)130–14 years (median 2.1 years)100 (34.2–100.0)63.6 (35.4–84.8)Retrospective cohort with limited CT verification
Huang et al., 2023(13)1520–6 years (median 2.9 years)91.7 (62.5–100)98.6 (94.6–100)Prospective observational study
Dehbozorgi et al., 2021(14)1680–14 years (mean 6.4 years)81.8 (48.2–97.7)100 (97.7–100)Prospective cohort
Parri et al., 2017(15)1150–2 years (mean 7.9 months)90.9 (82.9–96.0)85.2 (66.3–95.8)Prospective study
Rabiner et al., 2013(16)690–21 years (mean 6.4 years)88 (53–98)97 (89–99)Prospective study
DOI: https://doi.org/10.15557/jou.2025.0040 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
Language: English
Submitted on: Oct 23, 2025
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Accepted on: Dec 29, 2025
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Published on: Dec 31, 2025
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Wojciech Starczewski, Tomasz Waszak, Karolina Siwierska, Hanna Potoczna, Jan Bereda, Katarzyna Jończyk-Potoczna, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.