Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3

Quek, Samuel Enci; James, Vigil; Castillo, Leodivica; Tan, Ronald Ming Ren; Ong, Gene Yong-Kwang

doi:10.3390/children9060864

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Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3

by

Samuel Enci Quek

¹,

Vigil James

¹,

Leodivica Castillo

^1,2,

Ronald Ming Ren Tan

^1,2 and

Gene Yong-Kwang Ong

^1,2,*

¹

Department of Emergency Medicine, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore

²

Duke-National University of Singapore Medical School, 8 College Road, Singapore 169857, Singapore

^*

Author to whom correspondence should be addressed.

Children 2022, 9(6), 864; https://doi.org/10.3390/children9060864

Submission received: 24 May 2022 / Revised: 30 May 2022 / Accepted: 7 June 2022 / Published: 10 June 2022

(This article belongs to the Special Issue Pediatric Injuries: New Insights into Management, Prevention, and Education)

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Abstract

Patients with osteogenesis imperfecta (OI) are at an increased risk of pathological rib fractures even if there is no history of trauma. Early and accurate identification of such fractures are crucial for appropriate management. We present a case of a child with OI type 3 with multiple rib fractures who presented with transient cyanosis and increased work of breathing without a history of significant trauma. The patient’s chest radiographs were reported to have a single, new right posterior fourth rib fracture and an old, healing anterior fourth rib fracture. A point-of-care ultrasound performed by the attending pediatric emergency physician revealed additional findings of refracture over the old right anterior fourth rib fracture site and a new left posterior third rib fracture. These findings of multiple and bilateral rib fractures better account for the patient’s initial presentation. This case highlights the added advantages of ultrasound over conventional chest radiographs in the evaluation and diagnosis of a tachypnoeic pediatric patient with underlying metabolic bone disease and a complex skeletal structure with multiple pathological rib fractures but no chest tenderness.

Keywords: pediatrics; osteogenesis imperfecta; fractures; point-of-care ultrasound; emergency department

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MDPI and ACS Style

Quek, S.E.; James, V.; Castillo, L.; Tan, R.M.R.; Ong, G.Y.-K. Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3. Children 2022, 9, 864. https://doi.org/10.3390/children9060864

AMA Style

Quek SE, James V, Castillo L, Tan RMR, Ong GY-K. Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3. Children. 2022; 9(6):864. https://doi.org/10.3390/children9060864

Chicago/Turabian Style

Quek, Samuel Enci, Vigil James, Leodivica Castillo, Ronald Ming Ren Tan, and Gene Yong-Kwang Ong. 2022. "Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3" Children 9, no. 6: 864. https://doi.org/10.3390/children9060864

APA Style

Quek, S. E., James, V., Castillo, L., Tan, R. M. R., & Ong, G. Y.-K. (2022). Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3. Children, 9(6), 864. https://doi.org/10.3390/children9060864

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Point of Care Ultrasound Identification of Multiple Rib Fractures in a Pediatric Patient with Osteogenesis Imperfecta Type 3

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