The Effect of Bedside Ultrasound on Diagnosis and Management of Patients Presenting to a Sports Medicine Clinic With Undifferentiated Shoulder Pain

The objective of this study was to determine if point-of-care sonography of the shoulder would change diagnosis or management in patients presenting to a sports medicine clinic with shoulder pain. We performed an observational, nonrandomized, nonblinded study of provider behavior when evaluating patients presenting to a sports medicine clinic with shoulder pain. The provider completed a questionnaire regarding the most likely diagnosis and management plan after he or she had performed a physical examination and radiograph(s). Following the physical examination and radiograph(s), a bedside ultrasonographic examination (BUS) was done and the provider completed a second questionnaire regarding the findings on sonography and revisions, if any, to the diagnosis and management plan. Data were collected on 42 patient encounters. BUS led to a change in diagnosis in 53% of cases. BUS led to a change in management plan in 60.4% of patients. BUS increased provider confidence in the diagnosis from 3.7 ± 0.19 (95% confidence interval [CI]) to 4.5 ± 0.21 (95% CI) on a 1 to 5 scale, with 1 being least confident and 5 being most confident. The addition of bedside sonography to the physical examination and radiographic studies of patients with undifferentiated shoulder pain resulted in a significant number of changes to the diagnosis and management plan as well as significantly increased diagnostic confidence.
Source: Journal of Diagnostic Medical Sonography - Category: Radiology Authors: Tags: Original Articles Source Type: research