What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?

Objective: Our objective was to evaluate and appraise the existing evidence on the use of point of care ultrasound (POCUS) for pulled elbow, including its positive findings and their reliability. Methods: We searched PubMed, Medline, EMBASE, CINAHL and Google Scholar for prospective and retrospectiv...

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Main Authors: Salmah Lashhab, David McCreary
Format: Article
Language:English
Published: CINQUILL Medical Publishers Inc. 2025-04-01
Series:POCUS Journal
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Online Access:https://ojs.library.queensu.ca/index.php/pocus/article/view/17853
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author Salmah Lashhab
David McCreary
author_facet Salmah Lashhab
David McCreary
author_sort Salmah Lashhab
collection DOAJ
description Objective: Our objective was to evaluate and appraise the existing evidence on the use of point of care ultrasound (POCUS) for pulled elbow, including its positive findings and their reliability. Methods: We searched PubMed, Medline, EMBASE, CINAHL and Google Scholar for prospective and retrospective studies evaluating POCUS use for suspected pulled elbow. We identified positive sonographic findings along with their sensitivity and specificity relating to this diagnosis. Results: We included 13 studies that reviewed ultrasonographic findings in suspected pulled elbow. These studies discussed a range of sonographic findings between them, including radio- capitellar distance, ‘J-sign’/ ‘Hook sign’, fat pad sign and partial eclipse sign. The studies were of mixed quality and were susceptible to bias. Conclusions: Children presenting with suspected pulled elbow who have evidence of hook sign (or J-sign) and an absence of elbow effusion on POCUS can be diagnosed with pulled elbow and safely undergo reduction. POCUS can be used following reduction to demonstrate resolution of these signs and confirm its success. Elbow injuries with effusion are likely to have bony injury, meaning that X-ray is required. Additional prospective study of children presenting with elbow injury would be required to accurately determine the effectiveness of POCUS in the diagnosis of pulled elbow.
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spelling doaj-art-554c5addf19449f48cc04988ac6f7f6d2025-08-20T03:10:18ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432025-04-01100110.24908/pocusj.v10i01.17853What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?Salmah Lashhab0https://orcid.org/0009-0009-4520-9135David McCreary1https://orcid.org/0000-0001-9279-6162Paediatric Emergency Medicine Department, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, GBRPaediatric Emergency Medicine Department, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, GBR Objective: Our objective was to evaluate and appraise the existing evidence on the use of point of care ultrasound (POCUS) for pulled elbow, including its positive findings and their reliability. Methods: We searched PubMed, Medline, EMBASE, CINAHL and Google Scholar for prospective and retrospective studies evaluating POCUS use for suspected pulled elbow. We identified positive sonographic findings along with their sensitivity and specificity relating to this diagnosis. Results: We included 13 studies that reviewed ultrasonographic findings in suspected pulled elbow. These studies discussed a range of sonographic findings between them, including radio- capitellar distance, ‘J-sign’/ ‘Hook sign’, fat pad sign and partial eclipse sign. The studies were of mixed quality and were susceptible to bias. Conclusions: Children presenting with suspected pulled elbow who have evidence of hook sign (or J-sign) and an absence of elbow effusion on POCUS can be diagnosed with pulled elbow and safely undergo reduction. POCUS can be used following reduction to demonstrate resolution of these signs and confirm its success. Elbow injuries with effusion are likely to have bony injury, meaning that X-ray is required. Additional prospective study of children presenting with elbow injury would be required to accurately determine the effectiveness of POCUS in the diagnosis of pulled elbow. https://ojs.library.queensu.ca/index.php/pocus/article/view/17853Point-of-Care UltrasoundPulled elbowDiagnosisManagement
spellingShingle Salmah Lashhab
David McCreary
What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?
POCUS Journal
Point-of-Care Ultrasound
Pulled elbow
Diagnosis
Management
title What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?
title_full What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?
title_fullStr What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?
title_full_unstemmed What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?
title_short What is the Role of Point of Care Ultrasound for Suspected Pulled Elbow in Children?
title_sort what is the role of point of care ultrasound for suspected pulled elbow in children
topic Point-of-Care Ultrasound
Pulled elbow
Diagnosis
Management
url https://ojs.library.queensu.ca/index.php/pocus/article/view/17853
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