Diagnostic Utility of Ultrasound Versus Physical Examination in Assessing Knee Effusions

Meyer, Ryan; Lin, Chenyu; Yenokyan, Gayane; Ellen, Mark I.

doi:10.1002/jum.15676

Cited by 6 publications

(14 citation statements)

References 45 publications

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“…RTMSPUS not only addresses this problem but improves upon the known limitations of the physical examination. Just as the physical examination dramatically improves the accuracy of a verbal history in confirming suspected diagnoses, so does a focused POCUS examination dramatically improve upon a physical examination [ 29 , 30 , 31 ]. Thus, the authors suggest that a self-performed ultrasound examination be considered whenever a patient is perceived to potentially benefit from an improved physical examination during a remote medical encounter.…”

Section: Terrestrial Concepts Of Remote Telementored Self-performed U...mentioning

confidence: 99%

Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care

Kirkpatrick

McKee²,

Couperus³

et al. 2022

Diagnostics

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Point-of-Care ultrasound (POCUS) is an invaluable tool permitting the understanding of critical physiologic and anatomic details wherever and whenever a patient has a medical need. Thus the application of POCUS has dramatically expanded beyond hospitals to become a portable user-friendly technology in a variety of prehospital settings. Traditional thinking holds that a trained user is required to obtain images, greatly handicapping the scale of potential improvements in individual health assessments. However, as the interpretation of ultrasound images can be accomplished remotely by experts, the paradigm wherein experts guide novices to obtain meaningful images that facilitate remote care is being embraced worldwide. The ultimate extension of this concept is for experts to guide patients to image themselves, enabling secondary disease prevention, home-focused care, and self-empowerment of the individual to manage their own health. This paradigm of remotely telementored self-performed ultrasound (RTMSPUS) was first described for supporting health care on the International Space Station. The TeleMentored Ultrasound Supported Medical Interventions (TMUSMI) Research Group has been investigating the utility of this paradigm for terrestrial use. The technique has particular attractiveness in enabling surveillance of lung health during pandemic scenarios. However, the paradigm has tremendous potential to empower and support nearly any medical question poised in a conscious individual with internet connectivity able to follow the directions of a remote expert. Further studies and development are recommended in all areas of acute and chronic health care.

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Section: Terrestrial Concepts Of Remote Telementored Self-performed U...mentioning

confidence: 99%

Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care

Kirkpatrick

McKee²,

Couperus³

et al. 2022

Diagnostics

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“…Importantly, ultrasound cannot assess for early bony changes associated with osteomyelitis; thus, a negative study does not rule out this disease process. [13][14][15][16][17]…”

Section: Ultrasoundmentioning

confidence: 99%

“…Ultrasonography has superior sensitivity and specificity in the detection of knee effusion relative to the physical examination and is noninvasive, repeatable, and has no associated ionizing radiation. [13][14][15] Bedside ultrasound can be helpful in guiding joint aspirations, particularly in the patient with a small knee effusion. In the patient with juvenile idiopathic arthritis (JIA), ultrasound can also demonstrate signs of synovitis and associated inflammatory periarticular changes, thus assessing disease activity.…”

Section: Ultrasoundmentioning

confidence: 99%

Fever and Knee Effusion in the Pediatric Patient

Jafari

Woodward

2022

Pediatr Emer Care

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The pediatric patient with fever and knee effusion is always a cause for clinical concern. A thorough history and physical examination is required to guide appropriate diagnostic evaluation and management. Although pediatric knee effusions are common in the setting of trauma, the presence of fever should prompt consideration of infectious, rheumatologic, vasculitic, and malignant etiologies. This review covers the key components of the history, physical examination, diagnostic strategies, common etiologies, and initial management of the pediatric patient with fever and knee effusion.

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“…Although knee effusions are commonly believed to be clinically obvious, the diagnostic accuracy of physical examination tests lack accuracy and varies with examiner experience. A recent systematic review found the bulge sign to be 33% sensitive and the patellar tap to be only 15% sensitive for knee effusion [1]. Multiple studies have demonstrated that ultrasound is superior to clinical examination in the detection and localization of a knee effusion, as the physical examination is 69% sensitive and 85% specific compared to ultrasound [1].…”

mentioning

confidence: 99%

“…A recent systematic review found the bulge sign to be 33% sensitive and the patellar tap to be only 15% sensitive for knee effusion [1]. Multiple studies have demonstrated that ultrasound is superior to clinical examination in the detection and localization of a knee effusion, as the physical examination is 69% sensitive and 85% specific compared to ultrasound [1]. When reviewing the clinical examination for septic arthritis, only joint pain, history of joint swelling, and fever were found in more than 50% of patients [2].…”

mentioning

confidence: 99%