The Medical clinics of North America
-
Med. Clin. North Am. · Jan 2025
ReviewIntestinal Ultrasound in Common Gastrointestinal Disorders: An Evidence-Based Approach.
Patients with abdominal symptoms are among the most common to present both urgently and non-urgently for medical evaluation. While intestinal ultrasound (IUS) is useful to aid management of these patients, it is not routinely taught, performed, or included as part of the core set of point-of-care ultrasound competencies. The authors present an approach to performing a systematic, but focused, IUS at the bedside and diagnostic accuracies for small bowel obstruction inflammatory bowel disease, appendicitis, and diverticulitis. An approach on how to integrate IUS findings and common pitfalls will also be discussed.
-
Med. Clin. North Am. · Jan 2025
ReviewAdvanced Cardiac Point-of-Care Ultrasound: A Systematic Review of Select Cardiac Diseases.
Basic cardiac point-of-care ultrasound (POCUS)/focused cardiac ultrasound (FoCUS) often reveals incidental findings. Consider a patient with dyspnea in whom FoCUS reveals left ventricular (LV) hypertrophy, calcified valves, and pericardial effusion but "normal" LV systolic function. ⋯ This systematic review identified studies suggesting that a sufficiently trained practitioner can leverage advanced techniques to evaluate conditions such as hypertrophic cardiomyopathy (4), LV diastolic dysfunction (6), severe valvular heart disease (6), and tamponade (8). This article discusses the use of advanced cardiac POCUS in these conditions.
-
Med. Clin. North Am. · Jan 2025
ReviewBasic Lung Ultrasound and Clinical Applications in General Medicine.
Proficiency in basic lung ultrasound is highly recommended for clinicians in general and internal medicine. This article will review and provide guidance for novice users on how to use lung ultrasound in clinical practice, through a pathology-oriented approach. The authors recommend a 12-zone protocol and describe how to perform and apply it in clinical practice while examining patients with clinical suspicion for the following diseases: pleural effusion, heart failure, pneumonia (bacterial and viral), interstitial lung disease, and pneumothorax.
-
An increasing number of indications are emerging for point-of-care ultrasound to diagnose and treat musculoskeletal complaints. Low cost, dynamic imaging, immediate results, and added advantage of portability have made ultrasound an important imaging modality in urgent care, emergency department (ED), and other musculoskeletal care clinics. This article reviews the use of musculoskeletal ultrasound to help evaluate articular and periarticular structures to evaluate for mechanical injuries and inflammatory arthritis.
-
Ultrasound guidance for bedside procedures improves rates of success while reducing complications. It is the standard of care for most bedside procedures and has ever-increasing utility for peri-procedural assessment. Herein, we provide a concise description with associated images and videos detailing the proper technique for ultrasound image acquisition and interpretation, along with common pitfalls to be avoided.