Unveiling Hidden Fractures: Point of Care Ultrasound in Diagnosing Pediatric Clavicle Fractures Missed by X-ray

Clavicle fractures are a common injury presenting to the pediatric emergency department (PED) and account for 10% to 15% of all pediatric fractures. X-ray is the current standard imaging modality for the diagnosis of clavicle fractures though several studies in the literature have proposed the role of POCUS to be considered as a first-line imaging modality. We present 2 cases of paediatric clavicle fractures that were initially missed on X-ray before being identified using POCUS. POCUS has been shown to have a high diagnostic accuracy in detecting clavicle fractures with a sensitivity of 94% (95% CI: 89%-96%) and specificity of 98% (95% CI: 91%-99%) in one recent systematic review. POCUS should be considered as the first-line imaging modality in clavicle injuries in pediatric patients as it is highly accurate at detecting clavicle fractures, is quick and painless to perform, and is an easily teachable skill.