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Portable ultrasound (US) devices continue to improve in technical capabilities while cost decreases allow widespread use beyond traditional sports medicine settings.1 Using US at the field of play is an exciting advance in acute injury assessment. Images submitted as part of Hoffman et al2 review reflect state-of-the-art quality and great promise. By assessing for bone injury, athletes can be triaged on the field, possibly preventing further trauma by early return. However, ultrasonography examinations in general are highly user dependent, and lack of expertise in scanning can lead to significant error rates.
Ultrasonographic assessment of fractures has high utility and recent literature supports its use when conventional radiographs are unavailable. Specifically, multiple studies in the paediatric population have shown high sensitivity and specificity for US identification of long-bone fractures, while US assessment of paediatric rib fractures have demonstrated accuracy exceeding X-ray.3 However, much of literature on ultrasonographic assessment …