The Medical clinics of North America
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Point-of-care ultrasound (POCUS) provides immediate and useful information that aids clinical decision making at the bedside. The purpose of this article is to describe how POCUS can be integrated in the evaluation of the urinary system. ⋯ The rest of the article focuses on three common scenarios where POCUS can be integrated into clinical practice: hydronephrosis, nephrolithiasis, and bladder distension. The authors include evidence from the literature and describe commonly encountered pitfalls.
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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.
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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.
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Med. Clin. North Am. · Jan 2025
ReviewVolume Status: A Preload Assessment by Ultrasound of the Inferior Vena Cava and Jugular Venous Pulsation.
An accurate assessment of intracardiac pressure and etiology of its pathologic change is crucial in assessing volume status and cardiac hemodynamics. The assessment for abnormal central venous pressure in heart failure has driven the development of noninvasive assessment of the central veins: the inferior vena cava and, more recently, ultrasound assessment of the jugular venous pressure. This article discusses the evidence, techniques, and limitations of estimating central venous pressure by ultrasound assessment of the inferior vena cava and internal jugular vein.
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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.