Point-of-Care Sinus Ultrasound: Impact Within a Large Internal Medicine Clinic and Review of Technique

Outpatient Point-of-Care Ultrasound

The most commonly used outpatient primary care point-of-care ultrasound (POCUS) applications are similar to those used in the inpatient setting (eg, cardiac, pulmonary, and abdominal ultrasound). However, there are several additional POCUS applications that are highly applicable to the outpatient setting and should be considered for use by primary care practitioners. This article reviews 3 outpatient POCUS applications and their potential role in the primary care setting.

Digital diaphanoscopy of the maxillary sinuses: A revival of optical diagnosis for rhinosinusitis

PURPOSE

The non-invasive diagnosis of acute rhinosinusitis (ARS) remains an unresolved problem of modern otolaryngology. Analog diaphanoscopy of reduced transillumination (shading) could be enhanced by a digital image processing of the maxillary sinuses. By this means, the limited ergonomics of this safe and low-cost method can be overcome, and merits renewed the investigation. Here, we compared the diagnostic sensitivity and specificity of digital diaphanoscopy and computed tomography (CT) in detecting shading in the maxillary sinus.

MATERIALS AND METHODS

We examined 103 adults using both digital diaphanoscopy of the maxillary sinus and native-phase cranial CT. We developed a scoring system for investigation of shading in the maxillary sinus using diaphanoscopy and compared the sensitivity and specificity with that of CT. Also, we documented a follow-up of acute rhinosinusitis.

RESULTS

In diagnosing shading in the maxillary sinus, digital diaphanoscopy had a sensitivity of 86% and a specificity of 88%. Digital diaphanoscopy can be used not only in the screening of ARS but also for documentation of its course.

CONCLUSION

This study supports the role of modern digital diaphanoscopy in the diagnosis of shading in the maxillary sinus, especially in patients with ARS when CT imaging is not recommended. The ergonomics of analog diaphanoscopy could be significantly improved for physicians and patients by the implementation of modern hardware and software components. Further development of the technique and the use of several discrete wavelengths will improve this method's sensitivity and specificity.