2012 Ultrasound First Forum Proceedings

Consider ultrasound first for imaging the female pelvis

“…Since the advent of volume imaging in ultrasound imaging, reconstructed views of the pelvis (such as the coronal view of the uterus) have greatly improved our ability to use ultrasound imaging to answer the vast majority of clinical questions in gynecology. 1,10,11 Three-dimensional volume sonography has now become an essential new tool in the ultrasound armamentarium that has proved just as effective as MRI for the demonstration of Müllerian duct anomalies, which include cervical duplications ( Figure 1). [8][9][10][11] Threedimensional ultrasound imaging, like MRI, can produce an image of the uterine contour and the entire endometrial cavity simultaneously.…”

“…1 This tenet applies particularly to obstetric and gynecologic patients for whom a skillfully performed and well-interpreted ultrasound image usually obviates the need to proceed to additional more costly and complex cross-sectional imaging techniques. [1][2][3] Yet still today, many women with pelvic pain, masses, or flank pain first undergo computed tomography (CT) scans and those with Müllerian duct anomalies typically have magnetic resonance images (MRIs). [1][2][3][4][5] Not uncommonly, CT or MRI of the pelvis often yield indeterminate and confusing findings that then require clarification by ultrasound imaging.…”

“…[1][2][3] Yet still today, many women with pelvic pain, masses, or flank pain first undergo computed tomography (CT) scans and those with Müllerian duct anomalies typically have magnetic resonance images (MRIs). [1][2][3][4][5] Not uncommonly, CT or MRI of the pelvis often yield indeterminate and confusing findings that then require clarification by ultrasound imaging. The use of CT scans has tripled since 1993, and CT scans done in 2007 could result in as many as 29,000 future cancers in the United States, with the largest contribution to this risk arising from the CT of the pelvis and abdomen.…”

The Double Gut Point: A Novel Sonographic Sign of Pneumoperitoneum

“…The utility and scope of point-of-care ultrasound (POCUS) for evaluating and managing abdominal complaints in the ED has grown rapidly with little change in physician practice or patient awareness (6). Despite its increasing availability in every ED, POCUS is underused in evaluating many common abdominal chief complaints in the ED (7). In 2012 the "Ultrasound First Forum" met and created the Ultrasound First Campaign ( 7) to encourage research and change practices in clinical situations where initial evaluation with POCUS may be safer, less costly and time consuming.…”

A Cumbersome Rolling Stone

“…An ultrasound examination is the study of choice in patients with oliguria and renal failure . It allows anatomic and functional assessments of a range of possible etiologies responsible for renal failure or oliguria.…”