BRIEF REPORT
David Killeen, MD, MEd; Frances Shofer, PhD; Nova Panebianco, MD; Gwen Baraniecki-Zwil; Jeffery Kramer, MD, MSc
Corresponding Author: David Killeen, MD, MEd; Neighborhood Health
Email: davidkilleenmd@gmail.com
DOI: 10.3122/jabfm.2024.240465R1
Keywords: Family Medicine, Medical Education, POCUS, Point-of-Care Systems, Primary Health Care, Radiology, Soft Tissue Neoplasms, Technology, Ultrasonography
Dates: Submitted: 12-30-2024; Revised: 03-21-2025; Accepted: 03-31-2025
Status: In production.
INTRODUCTION: Soft tissue concerns are common, yet most primary care physicians must refer patients to radiology for further imaging, leading to potential delays in diagnosis and management. Point of care ultrasound (POCUS) is increasingly available in primary care and has been shown to improve clinical decision-making. However, current Family Medicine POCUS curricula focus primarily on cellulitis and abscess, overlooking other common soft tissue pathologies. This study aims to evaluate the frequency of soft tissue pathologies and associated follow-up recommendations on comprehensive radiology ultrasound exams ordered by Family Medicine physicians.
METHODS: A retrospective analysis was conducted radiology-performed ultrasounds ordered by an academic Family Medicine practice in 2019. Data collected included patient demographics, ultrasound findings, anatomical location, and follow-up recommendations. Diagnoses were categorized, and time from order to completion was calculated.
RESULTS: Soft tissue ultrasounds comprised 10% (n=168) of all ultrasound studies ordered. The most common diagnosis were lymph nodes, n=44 (25%), lipomas n=32 (18%), and no lesion/normal n=23 (13%). Only two studies diagnosed abscess (1%). The median time from order date to completion was 6 days (IQR 2-22 days), with 48% waiting over a week. Half (51%) of studies required no further follow up, while 26% required additional imaging or biopsy
DISCUSSION: There findings highlight the need for expanded Family Medicine POCUS training to include high-yield diagnoses such as lipomas, lymph nodes, and cysts. POCUS could reduce unnecessary referrals, expedite care, and improve diagnostic confidence. Future research should explore primary care-specific POCUS protocols and their impact on patient outcomes.