Patients visiting their physician with right upper quadrant (RUQ) pain may have vague symptoms that are difficult to diagnose. A condition that physicians commonly check for is gallstones, but it is difficult to reliably diagnose with a physical exam and review of medical history alone.
Bedside handheld ultrasound is an option for providers who are interested in expanding their ability to diagnose patients who are clinically suspected of having acute calculous cholecystitis.
In an era where the relationship between physicians and patients is increasingly more important, having access to portable, handheld technology can benefit both the patient and the medical provider.
Handheld ultrasound is a technology that supports physician’s fast diagnosis of gallstones and allows them to swiftly move on to treatment. Not only is the use of handheld technology more efficient but is often less expensive for providers as well.
There are roughly 1 million people diagnosed with gallstones in the United States yearly, and some patients require surgical treatment. Handheld ultrasound for gallstones expedites the process, allowing physicians to spend time preparing patients for treatment as needed.
Why Handheld Ultrasound for Gallstones
According to a piece in the Atlas of Handheld Ultrasound, “Bedside [ultrasound (US)] of the biliary system has been shown to decrease the costs as well as emergency department length of stay in patients with cholelithiasis. Bedside US can detect gallstones, a thickened gallbladder wall, pericholecystic fluid, and a sonographic Murphy sign to assist in diagnosis of acute cholecystitis. Also, point-of-care US for gallbladder disease is a skill that can be learned by physicians at all levels of training.”
Pocket-sized mobile ultrasound devices (PUDs) have also been found to be a helpful addition to the physical exam. According to a study published in PLOS One, “After a simple and short training course, a PUD examination can be used in addition to a physical examination to improve the answer to ten common clinical questions concerning in- and outpatients and can reduce the need for further testing.” The reduction in further testing is beneficial to both the patient and the already taxed medical system.
Access to handheld technology can help physicians arrive at a diagnosis more quickly, thus avoiding potential complications that arise from gallstones. When medical providers can avoid increased pain for the patient — from blocked bile ducts, infection, or jaundice — it can save the patient from added stress to their system. The more high risk categories the patient falls in, the more beneficial to diagnose and start treatment as quickly as possible. Risk factors that contribute to an increased likelihood of developing gallstones include age, gender, weight, pre-existing conditions, medications, and family history.
How Handheld Ultrasound for Gallstones Stacks Up
Handheld ultrasound offers clinicians portability and easy point-of-care imaging that ultimately transforms the traditional physical exam and expands its capabilities into areas that were previously only available through slow and expensive testing. According to the Journal of Ultrasound in Medicine, “Point-of-care examinations with a pocket-size imaging device increased medical residents’ diagnostic accuracy and capability.” With a handheld ultrasound device, gone are the days of patients waiting for their turn in the ultrasound room, and physicians taking turns using equipment. Not only are bedside ultrasound devices portable, but they are more cost efficient. Therefore, multiple devices mean multiple providers can be using equipment at the same time to diagnose patients. While ultrasound equipment is commonly used in obstetrics, there are many other use cases for ultrasound technology (including for gallstones).
Additionally, a study in the Internal and Emergency Medicine journal noted, “PSUD is a reliable tool for the diagnosis of cholelithiasis when used by expert operators potentially reducing the need for further diagnostic tests. It can even be successfully used by non-expert operators in outpatients setting after a short-focused training.”
Acquisition of handheld ultrasound devices often is accompanied with training that allows a wider range of users to become fluent in the use of portable technology. Wider usage by medical providers not only helps the patient (with more users being able to operate the equipment) but will provide more support for physicians who are already limited on time.
As diagnostic demands on physicians increase, handheld ultrasound options could be a primary consideration for physician leaders who want to best serve their patients, improve outcomes and increase the effectiveness of individual practitioners. Additionally, as more equipment becomes available to physicians — the patient may spend less time going to specialists. Not only is it time consuming for patients to have multiple appointments at various locations, but the financial implications and emotional stress can be daunting for them as well. Arriving at a medical diagnosis in one appointment will help save the patient time and money while avoiding added anxiety.
The Benefits of Handheld Ultrasound for Gallstones
To summarize, there are many benefits to both patients and physicians for the use of handheld ultrasound technology to diagnose gallstones. When medical providers are attempting to diagnose a patient who is in pain and exhibiting symptoms that could be tied to multiple ailments, time is of the essence. The potential benefits of gallstones ultrasound include:
- Faster diagnosis
- Lower equipment cost for medical providers
- Access to more equipment
- Accurate imaging for precise diagnosis
- Equipment training and certification
- Lower cost for patients
- Less time drain for patients (and physicians)
- Enhanced patient-doctor relationship