{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:26:30Z","timestamp":1793049990566,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T00:00:00Z","timestamp":1725667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:label\/><jats:p>Radial head subluxation, known as pulled elbow or nursemaid's elbow, is a common presentation to the Paediatric Emergency Department (PED). Fifty per cent of children present following an unwitnessed injury or with an atypical history. Furthermore, examination can be difficult in an upset or frightened child meaning the precise location of the injury is not always easily identifiable. Many children receive upper limb x\u2010rays unnecessarily and others undergo attempted reduction for suspected pulled elbow when a fracture is the cause of their pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the ability of point\u2010of\u2010care ultrasound (POCUS) to correctly identify cases of suspected pulled elbow.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients aged 0\u20135\u2009years presenting to the PED of our large District General Hospital from November 2020 to November 2022. We reviewed the electronic medical records of all patients presenting with a triage category of \u2018elbow Injury\u2019. We excluded patients presenting with obvious deformity, significant swelling and history of road traffic collision or other major trauma mechanism such as a fall from a height. POCUS was carried out by the authors according to pre\u2010existing clinical protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010seven patients underwent POCUS. Twenty\u2010nine had a typical history and all had a positive POCUS for pulled elbow. Of the remaining eight patients with an atypical history, three were found to have a positive POCUS compared to unaffected elbow. Five patients with an atypical history had negative POCUS findings and were diagnosed as soft tissue injuries after further assessment. All 32 with positive sonographic signs had a final diagnosis of pulled elbow, meaning the specificity was 100% (47.8\u2013100) (<jats:italic>P<\/jats:italic>\u2009=\u20090.00003). The sensitivity was 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Use of POCUS by appropriately trained clinicians, as an extension of a clinical examination, in this retrospective study reliably confirmed pulled elbow. This has the potential to reduce both unnecessary radiation as well as the time in the emergency department for the child and their carers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16659","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T13:03:40Z","timestamp":1725714220000},"page":"698-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["What is the utility of point\u2010of\u2010care ultrasound for suspected pulled elbow? A single\u2010centre case series"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-6162","authenticated-orcid":false,"given":"David J","family":"McCreary","sequence":"first","affiliation":[{"name":"Paediatric Emergency Department Sunderland Royal Hospital  Sunderland United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Tambe","sequence":"additional","affiliation":[{"name":"Paediatric Emergency Department Sunderland Royal Hospital  Sunderland United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"Mullen","sequence":"additional","affiliation":[{"name":"Paediatric Emergency Department Sunderland Royal Hospital  Sunderland United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(95)70117-6"},{"key":"e_1_2_7_3_1","volume-title":"Fundamentals of Pediatric Orthopedics","author":"Staheli LT","year":"2008"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.09.002"},{"key":"e_1_2_7_5_1","first-page":"312","article-title":"Missed elbow fractures misdiagnosed as radial head subluxations","volume":"76","author":"Kraus R","year":"2010","journal-title":"Acta Orthop. 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