It has been many decades since any new piece of equipment found its way into the internist’s black bag. The stethoscope, neurologic hammer, otoscope, and ophthalmoscope have been there for approximately 200 years. Recently, however, there has been a flurry of investigative work involving a new diagnostic tool with considerable potential for everyday use in internal medical practice: the portable ultrasound machine.
It is an unfortunate fact that the traditional internal medicine physical examination often overlooks or erroneously interprets findings, resulting in missed or incorrect diagnoses.(1, 2) Noninvasive diagnostic techniques, such as ultrasound imaging, have greatly enhanced the ability of the physicians to detect occult or unapparent pathologic conditions. Recent technical advances have miniaturized ultrasound imaging equipment to the point where it can be comfortably carried and used by an internist making daily hospital rounds or working in the office. The use of such hand-held ultrasound devices has been demonstrated to increase significantly a physician’s ability to detect a variety of disease states compared with physical examination alone.(3, 4, 5)
The cost for hand-carried ultrasound (HCU) devices has declined sharply over recent years, and the use of these systems has become increasingly more common. A full-sized office and hospital ultrasound machine, such as those used by internists and radiologists in hospitals, is approximately $250,000. The miniaturized, portable ultrasound devices range in price from $9000 to 40,000. As their use becomes more common, it is likely that prices will decline even further.
What are the various areas of internal medicine in which the daily use of an HCU device might be valuable?
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– Joseph S. Alpert, MD, Jeanette Mladenovic, MD, MBA, David B. Hellmann, MD
This article was originally published in January 2009 issue of The American Journal of Medicine.
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Hand-carried Ultrasound Performed by Hospitalists: Does It Improve the Cardiac Physical Examination?
