Limitations of Ultrasound Examination in Trauma

Introduction: Ultrasound examination plays a significant role in the evaluation of patients with trauma and polytrauma because it is an examination that provides information for many regions and systems, such as in the case of abdominal trauma, cardio-thoracic trauma, and vascular and musculoskeletal injuries. Ultrasound examination is used to rapidly and accurately detect hemorrhages in the pericardial, pleural, and peritoneal cavities, turning it into a necessary examination in Advanced Trauma Life Support (ATLS). Ultrasound is also used in traumas such as pneumothorax, damage to parenchymal organs and abdominal cavity, as well as rib and sternum fractures. Material and Methods: This study considered and revised a systematic review of radiology and ultrasound specialty journals and clinical textbooks, the bibliographies of all identified articles, and meta-analyses about the role of ultrasound in trauma, especially FAST. Both prospective and retrospective studies for different types of trauma, such as abdominal trauma and thoracic trauma, trauma with unique injuries and polytrauma, and blunt and penetrating trauma, were included. Conclusions: Although a necessary non-invasive radiological examination, ultrasound has long-term limitations during the evaluation of trauma. Ultrasound limitations are divided into technical limitations, image quality, the inability of sonographic windows to acquire images, echogenic similarity, and lack of differentiation between structures and organs.