Extracted data illustrating the studies’ characteristics and main finding
| Study | N | Age (years) | Index test | Reference standard | Transducer/operator | Sampling | Primary outcome | Results |
| Lalande et al 18 | 96 | Median: 54 (IQR: 38–69) | LUS CXR | None | Transducer: NS Emergency physician | Consecutive | Feasibility of PoCUS for rib # diagnosis using VAS score | 32% pts had a # on either modality. 29% pts had # on LUS not seen on CXR. 12% pts had # on CXR not seen on LUS. |
| Lee et al 19 | 93 | Mean: 51 (17–78) | LUS | CXR, MDCT | 7.5 MHz linear Two radiologists | Consecutive | Presence of costal cartilage fracture | 69% pts had a chrondral # on LUS, not seen on CXR or MDCT. |
| Paik et al 20 | 58 | Mean: 61 (22–88) | LUS, CXR | Bone scan | 5–12 MHz linear Operator NS | Consecutive | Presence of rib lesion (fracture or metastasis) | 97% pts with rib # identified on LUS (cf bone scan). 43% pts with rib # identified on CXR (cf bone scan). |
| Rainer et al 21 | 88 | Mean: 51 (SD: 19) | LUS, CXR, Clinical acumen | LUS at 3 weeks | 5–9 MHz linear Radiologist | Consecutive | Presence of rib fracture | Sensitivity: LUS: 80.3 (69.5–88.5) CXR: 23.7 (14.7–34.8) CA: 26.0 (15.8–36.3) Specificity: LUS: 83.3 (51.6–97.4) CXR: 91.7 (61.5–98.6) CA: 91.7 (61.5–98.6). |
| Kara et al 22 | 37 | Mean: 42 (16–85) | LUS | CXR | 7.5 MHz linear Operator NS | Consecutive | Presence of rib fracture | 40.5% pts had rib # on LUS not seen on CXR. 59.5% pts had no # on LUS (as interpreted on CXR). |
| Turk et al 23 | 20 | Mean: 47 (25–68) | LUS, CXR | LUS at 7–12 days | 12.5 MHz linear Radiologist | Consecutive | Presence of rib fracture | 90% pts had rib #s on LUS not seen on CXR. This confirmed at follow-up LUS. |
| Hurley et al 7 | 14 | Mean: 31 (16–55) | LUS, CXR standard and oblique views) | None | 12.5 MHz linear Radiologist | Consecutive | Presence of rib fracture | n=14 rib #s seen on LUS. n=11 rib #s seen on PA CXR. n=13 rib #s seen on oblique CXR. |
| Hwang and Lee24 | 201 | Mean: 48 (3–91) | LUS, CXR | None | 12 MHz Operator NS | Consecutive | Presence of rib fracture | 70% pts had rib # on LUS not seen on CXR. 48% pts had additional rib # on LUS to number identified on CXR. |
| Griffith et al 25 | 50 | Mean: 50 (24–89) | LUS, CXR | LUS at 3 weeks | 9/12 MHz linear Operator NS | Case series | Presence of rib fracture | n=83 rib #s in 39 (78%) of pts on LUS. n=8 rib #s in 6 (12%) of pts on CXR. n=12 additional rib #s in 9 pts (4 of whom who had no # on initial LUS) on 3-week follow-up LUS. |
| Wüstner et al 26 | 100 | NS | LUS, CXR | None | 3.5–7.5 MHz linear. Operator NS | Consecutive | Presence of rib fracture | 65% pts had rib #s on LUS compared with 36% pts on CXR. |
| Wischhofer et al 27 | 21 | NS | LUS, CXR | Bone scan | 5 MHz linear. Operator NS | Case series | Presence of rib fracture | 76% (n=16) pts had rib #s not seen on CXR. 11 of these 16 had signs of rib # on bone scan. |
| Bitschnau et al 28 | 103 | Mean: 54.3 Range NS | LUS, CXR | None | 7 Mhz linear, 3.5–5 MHz linear rarely. Operator NS | Consecutive | Presence of rib fracture | 58% of pts had rib #s on LUS. 0% of pts had rib # on PA CXR. 30% of pts had rib #s on targeted CXR. |
| Martino et al 29 | 5 | Mean: NS (34–63) | LUS, CXR | None | 7.5 MHz linear, Operator NS | Case series | Presence of rib fracture | 90% of pts had rib #s on LUS. 0% of pts had rib #s on CXR. |
#, fracture.
#, fracture; CA, clinical acumen; LUS, lung ultrasound; MDCT, multidirectional CT scan; NS, not stated; pts, patients; PoCUS, point-of-care ultrasound scan; VAS, visual analogue scale.