The Role of Point of Care Ultrasound (PoCUS) in Orthopaedic Emergency Diagnostics

Oluku, Jennifer; Stagl, Attila; Cheema, Kamalpreet S; El-Raheb, Karmen; Beese, Richard

doi:10.7759/cureus.13046

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…Finally, we know that the use of ultrasound in patient care (Point of Care Ultrasound -POCUS) has increased in recent decades due to its size and availability in both emergency and outpatient settings, allowing for quicker diagnoses and decision-making. The usefulness of ultrasound in orthopedics has been demonstrated, such as in cases of joint effusions, tendon ruptures, and hidden fractures (22). This often results in fewer tests, such as computed tomography scans, magnetic resonance imaging, and electroneuromyography, which can increase costs, be harmful, and be uncomfortable for patients.…”

Section: Discussionmentioning

confidence: 99%

Dynamic ultrasound evaluation of the ulnar nerve at the elbow in a healthy Colombian population

Jiménez,

Rivera,

González

2024

Preprint

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Background The diagnosis of cubital tunnel syndrome is traditionally based on the patient's medical history, findings from physical examination, and electromyography. However, with the advancement of ultrasound as a diagnostic tool, which is more comfortable for patients than is electromyography, there has been research and exploration into the possibility of using ultrasound measurements as a diagnostic method for cubital tunnel syndrome. Hence, it is convenient to familiarize a healthy population with ultrasound measurements. Methods Forty healthy volunteers (20 women and 20 men) underwent ultrasound (US) of the ulnar nerve at two different time points. In this observational study, we measured the short and long axes of the nerve, the cross-sectional area of the nerve, the nerve-trochlea distance, the width, and the depth of the epicondylar groove at different degrees of elbow flexion-extension and at different levels. We also determined the number of individuals who presented with dislocation or subluxation of the nerve in relation to the tip of the epicondyle at different degrees of elbow flexion-extension. Additionally, we calculated whether there were changes in the flattening index. Statistical analysis was performed using tests for normality with the Shapiro‒Wilk test, the median and interquartile range were used as summary measures. Subsequently, for continuous variables, comparisons of values between two groups were conducted using the Mann‒Whitney, and Kruskal‒Wallis test were applied. Results Women and men have median ultrasound cross-sectional nerve area measurements of 4.0 mm² and 5.0 mm², respectively, at the level of the medial epicondyle with the elbow flexed at 90 degrees. No statistically significant differences were found between measurements taken and calculated values regarding the ultrasound morphology of the elbow and ulnar nerve in individuals between the first and second measurements. Men have greater nerve-trochlea distances, groove widths, and cross-sectional areas (both ultrasound and formula-derived) than women at various elbow measurement locations. Individuals with a body mass index (BMI) > 25 have a larger ulnar nerve diameter than individuals with a BMI < 25. Conclusions This study provides normative data on ulnar nerve ultrasound at the elbow in a Latin-American population.

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Section: Discussionmentioning

confidence: 99%

Dynamic ultrasound evaluation of the ulnar nerve at the elbow in a healthy Colombian population

Jiménez,

Rivera,

González

2024

Preprint

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“…18 Its use in intensive care units and emergency departments is becoming increasingly common. 19,20 Oluku et al 21 achieved excellent results in bone fracture diagnostics. In comparison with radiologists, diagnostic compatibility with high sensitivity and specificity was observed.…”

Section: Main Pointsmentioning

confidence: 99%

Assessment of Compatibility Between Cardiologists and Radiologists for Interpreting and Reporting Carotid Duplex Ultrasound Images

Günlü

Aktan

2022

Eur J Ther

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Objective: This study aimed to evaluate the degree of agreement between cardiologists and radiologists for interpreting and reporting carotid duplex ultrasound images. Methods: This prospective observational study was conducted in a cardiology outpatient clinic. For the sample size calculation, according to the kappa (2 raters) hypothesis testing method, assuming minimum acceptable kappa of 0.6, expected kappa of 0.8, a significance level of 0.05, power of 90%, and considering the expected dropout rate of 10% in the study, 116 patients were enrolled in the study. Demographic findings, personal histories, and laboratory test results were recorded. Carotid artery duplex ultrasonography was performed simultaneously and recorded by cardiologists and radiologists. Results: This study included 116 patients who were treated in cardiology outpatient clinics for ischemic stroke, trans-ischemic attack, amaurosis fugax, dizziness, and severe headache complaints. While 50.9% of them are female, 49.1% were male. The age range of patients included in the study was a minimum of 32 years and a maximum of 71 years. Their mean age and deviation were 58.6 ± 10.1. Examination of their distribution according to chronic disease states revealed that 44.8% had hypertension, 58.6% were smokers, 36.2% had diabetes mellitus, 22.4% had dyslipidemia, 13.8% had ischemic heart disease, 29.3% had chronic obstructive pulmonary disease, and 16.4% had congestive heart failure. According to the criteria for carotid stenosis measurement of ≤50% and >50%, a significant and almost perfect agreement was found between the measurements by cardiologists and radiologists (Cohen's kappa coefficient κ = 0.811; P < .0001). Conclusion: Diagnostic compatibility with radiologists was found to be near-perfect for carotid ultrasound evaluation.

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“…POCUS can be used as an alternative imaging method to XR in the diagnosis of Long Bone fractures and in the determination of fracture characteristics. [24,25] The addition of POCUS to a physical examination significantly improves diagnostic accuracy for dislocations, proximal humeral fractures and reduction confirmation. [26] Military Military clinicians demonstrated the ability to perform focused exams, including FAST exams and fracture detection with acceptable sensitivity and specificity.…”

Section: ) Ultrasoundmentioning

confidence: 99%

Role of point of care diagnostics in Lower-and Middle-income countries and austere environments

Ganchi¹,

Hardcastle²

2023

Preprint

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Introduction: Austere environments include the wilderness and many lower-and-middle-income countries, many of these facing unrest and war. The access to advanced diagnostic equipment is often unaffordable even if available and is often liable to breakdown. This short review paper examines the options available to medical professionals to undertake clinical and point of care diagnostic testing in resource constrained environments and also illustrates the development of mobile advanced diagnostic equipment. The aim is to provide an overview of the spectrum and functionality of these devices beyond clinical acumen.

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The Role of Point of Care Ultrasound (PoCUS) in Orthopaedic Emergency Diagnostics

Cited by 10 publications

References 21 publications

Dynamic ultrasound evaluation of the ulnar nerve at the elbow in a healthy Colombian population

Dynamic ultrasound evaluation of the ulnar nerve at the elbow in a healthy Colombian population

Assessment of Compatibility Between Cardiologists and Radiologists for Interpreting and Reporting Carotid Duplex Ultrasound Images

Role of point of care diagnostics in Lower-and Middle-income countries and austere environments

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