Diagnostyka ultrasonograficzna w gabinecie lekarza rodzinnego – przegląd piśmiennictwa

Abstract

Ultrasound, which is a safe and non-invasive diagnostic modality that uses more and more advanced imaging techniques, has become the first-choice examination in various diseases. It is more and more often used in the general practitioner's office to supplement physical examination and interview.AimThe aim of this paper is to review the Polish medical literature pertaining to the usage of ultrasound imaging in general practice as well as to present advantages, disadvantages and utility associated with conducting ultrasound examinations by general practitioners based on selected publications.Material and methodsThe analysis involved 15 articles found in Polish medical literature published in 1994–2013 in 9 medical journals. These publications were obtained using various data bases, such as Polish Medical Bibliography, Google Scholar as well as websites of “Lekarz Rodzinny” and “Ultrasonografia.”ResultsOf 15 available publications, 5 papers present the usage of ultrasound imaging by a primary care physician for general purposes, 4 discuss the usage of abdominal scans, 3 – imaging of the neck and lymph nodes, 1 – lungs, and 2 discuss its usage for specific disease entities. In over 70% of the papers, the financial aspect associated with the usage of this modality in general practice is mentioned. More than a half of the publications draw attention to the possibility of using point-of-care ultrasound examinations. Advantages of ultrasonography most often mentioned by the authors include: good effects of screening, safety, short duration and low cost. The authors of eight publications also indicate disadvantages associated with ultrasound imaging used by a general practitioner.ConclusionsIn the Polish literature, there are relatively few papers on the role of ultrasonography in the office of a primary care physician. This modality is more and more often becoming a tool that helps primary care physicians to establish diagnoses, accelerates the initiation of treatment and directs the further diagnostic process.

Experiences of family physicians after a CME ultrasound course

“…Genc et al [6] and kosiak [5] claim that ultrasound scan performed by a family physician in accordance with the point-of-care principle (i.e., performing the examination and interpreting the result in the course of making a therapeutic decision, in order to confirm the suspected pathology) does not extend the time of the visit, because the time taken for the examination of, for example, the lungs is similar when performed by ultrasound and by stethoscope.…”

“…Ultrasonography is a relatively inexpensive, safe, and noninvasive diagnostic tool [2], and its use of dynamic spatial imaging [3] often allows for a diagnosis to be made without the need to perform further imaging tests [4]. as the 'new stethoscope' of a family physician, the ultrasound scanner [5] increasingly contributes to the faster onset of therapy [6] and quicker referral of patients to further diagnosis or specialist care [7].…”

“…the fact that family physicians can obtain the overall picture of a disease through their knowledge of their patients, their disease histories, clinical symptoms, and the results of additional tests (including an ultrasound) [5,6,15] should be a fundamental argument for the popularization of ultrasound diagnosis in family physician's practices, as well as improving the methods and forms for educating this group of physicians to perform ultrasounds properly. Evangelista et al [16] have claimed that handheld ultrasound performed at the point of care by family doctors, with remote expert support interpretation using a web-based system, is feasible, rapid, and useful for detect-ing significant echocardiographic abnormalities and decreasing the number of unnecessary echocardiographic tests.…”

Weekend courses on ultrasonography as a form of teaching knowledge and the skills necessary to perform ultrasounds in the family physician’s practice

“…according to Genc et al, a UsG scanner is an element that, apart from the knowledge and skills of the physician, relates to the value of UsG examinations [4]. Gajewicz concluded that buyers should use the guidelines of the Polish UsG society when choosing a UsG scanner, as both the class and age of the equipment determine the quality of the UsG image [20].…”

“…Examination results and further diagnosis of patients depend on the professionalism of the UsG operators, their qualifications and experience [4,5]. the royal College of radiologists in the Uk gives advice on UsG training, stating "operators are ethically and legally vulnerable if they have not been adequately trained" [6].…”