Evaluation of AI-assisted radiography for pediatric upper limb fractures

Evaluation of AI-assisted radiography for pediatric upper limb fractures

Product: BoneView Company: Gleamer


Diagnostic value of artificial intelligence-based software for the detection of pediatric upper extremity fractures

European Radiology, 2025

Abstract

Objectives

Fractures in children are common in emergency care, and accurate diagnosis is crucial to avoid complications affecting skeletal development. Limited access to pediatric radiology specialists emphasizes the potential of artificial intelligence (AI)-based diagnostic tools. This study evaluates the performance of the AI software BoneView® for detecting fractures of the upper extremity in children aged 2–18 years.

Materials and methods

A retrospective analysis was conducted using radiographic data from 826 pediatric patients presenting to the university’s pediatric emergency department. Independent assessments by two experienced pediatric radiologists served as reference standard. The diagnostic accuracy of the AI tool compared to the reference standard was evaluated and performance parameters, e.g., sensitivity, specificity, positive and negative predictive values were calculated.

Results

The AI tool achieved an overall sensitivity of 89% and specificity of 91% for detecting fractures of the upper extremities. Significantly poorer performance compared to the reference standard was observed for the shoulder, elbow, hand, and fingers, while no significant difference was found for the wrist, clavicle, upper arm, and forearm. The software performed best for wrist fractures (sensitivity: 96%; specificity: 94%) and worst for elbow fractures (sensitivity: 87%; specificity: 65%).

Conclusion

The software assessed provides diagnostic support in pediatric emergency radiology. While its overall performance is robust, limitations in specific anatomical regions underscore the need for further training of the underlying algorithms. The results suggest that AI can complement clinical expertise but should not replace radiological assessment.

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Diagnostic value of artificial intelligence-based software for the detection of pediatric upper extremity fractures