The ultrasound-assisted physical examination in the periodic health evaluation of the elderly.
BACKGROUND
Except for specific procedures such as blood pressure measurement, the conventional physical examination (PE) does not have sufficient sensitivity to be useful as part of the periodic health evaluation. Ultrasound has demonstrated greater sensitivity and specificity in numerous studies but has been too expensive to be widely employed in health screening. The purpose of our study was to determine whether an examination in which conventional and ultrasound techniques are blended and applied by a primary care physician might be feasible and useful in the periodic health evaluations of senior citizens.


METHODS
Seventy-two patients presenting to a community-based family physician for periodic health evaluations received an ultrasound-assisted physical examination (USA-PE) from a second family physician. The results were reported to the primary physician, and the outcomes were tracked for periods of up to 2 years.


RESULTS
Twenty-two of the 72 patients (31%) had abnormalities found by the USA-PE that were not apparent during the conventional PE. Five of these patients (7%) had serious conditions that received prompt treatment with apparent benefit. Findings included endometrial carcinoma, abdominal aortic aneurysm, carotid stenosis, hydronephrosis, and urinary retention.


CONCLUSIONS
The USA-PE found more abnormalities in this group of patients than conventional PE. Whether it can improve outcomes for senior citizens undergoing periodic health evaluations in a cost-effective manner is yet to be determined.
Department of Family Medicine, State University of New York at Buffalo, USA. siepel@aol.com
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T
Siepel
D S
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Clifford
P A
PA
James
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Cowan
D000368:Aged; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D003365:Costs and Cost Analysis; D005194:Family Practice; D015577:Geriatric Assessment; D006801:Humans; D009518:New York; D010808:Physical Examination / Q000379:methods* / Q000592:standards; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000191:economics / Q000592:standards; D014570:Urologic Diseases / Q000000981:diagnostic imaging