Title : Emerging role of point of care ultrasound in orthopaedics
Abstract:
Background and aim: Point of care ultrasound (PoCUS) are used in multiple settings including bedside, clinic. It is also known to contribute to various specialties such as accidents and emergencies as well as obstetrics and gynaecology. We investigate the effectiveness of PoCUS in our hand services. We also aim to describe the importance of PoCUS in the assessment and management of carpal tunnel syndrome.
Method: Data about PoCUS scans completed by a single surgeon in outpatient clinic from 2021 to 2023 were collected. Data collected include patient demographic, setting of scans, pathology, body part scanned, and management. Managements were described as procedure done at first consultation, listed for surgery and/or requiring further investigations.
Results: From the surgical practice of a single surgeon over a course of 3 years, 380 patients received PoCUS at first assessment. Among these, almost one-third of patients had a procedure done at first consultation. This can include an US guided aspiration or injection. Thirteen percent of patients were referred on for further investigations. Approximately one third of patients were listed for an operation. We found the most common diagnosis was Carpal Tunnel Syndrome (CTS). This could be quickly diagnosed from first assessment and provided with treatment as well as listed for operation in the same consultation.
Conclusion: PoCUS has demonstrated its effectiveness in supporting a diagnosis at first consultation and allow for treatment, especially for patients with carpal tunnel syndrome. It reduces waitlist for other imaging as it provides a conclusive results and comparison for pre-operation. Further investigations were required only if there were ambiguity in diagnosis. It also helps ensure patients were only listed for necessary operations and thus, increases theatre space for other cases. We highly support orthopaedic trainee opportunities to conduct PoCUS in their orthopaedic unit.
What will audience learn from your presentation?
- Importance of bedside PoCUS in an orthopaedic setting. Consider expansion in other joint clinics.
- Discussion of role of PoCUS and the benefits in patients with carpal tunnel syndrome.
- Recommendation for training opportunities for orthopaedic trainees to fully utilize PoCUS.
