Clinical ultrasound is the use of ultrasound by the same physician who attends the patient, used at the bedside, for a specific problem or diagnosis (the exhaustive exploration is left to the radiologist). Its usefulness and learning is gaining ground all over the world and, given the undeniable advantages it provides in terms of immediacy and more precise diagnoses, it has been incorporated into many study programs in medical schools.
It is said that the ultrasound is the phonendoscope of the 21st century and, of course, it is so in Cardiology, where it has been demonstrated that resident doctors (learning the specialty) with a few cardiac ultrasound classes can outperform cardiologists, if the latter try to diagnose using only the phonendoscope.
In the other great classical utility of the phonendo, the exploration of the respiratory tract, ultrasound is also displacing the phonendo in some processes and thus is very useful in bronchiolitis in young children, in pneumonia it is of similar value to radiography (but without subjecting the patient to radiation) and with respect to Covid-19, superior to radiography and clinical examination together, and it has even been stated that “ultrasound is made for Covid-19”.
Moreover, in all these situations it can be used repeatedly to see the evolution of the process.
But the usefulness of bedside ultrasound for the pediatrician does not end there:
- In the neck, to assess enlarged lymph nodes that worry parents so much; also to assess thyroid and salivary glands.
- In the skull, for example, to assess macrocephaly (enlarged head) and check whether or not it is hydrocephalus and also to assess, without radiographs, the sutures of the skull bones, in case the shape of the child’s skull is abnormal.
- In the abdomen, to assess gastro-esophageal reflux, so common in infants; for abdominal pain and vomiting; to assess the liver and to measure the spleen which is enlarged in the frequent infectious mononucleosis, wrongly called “kissing disease”. Very useful for visualizing the kidneys and urinary bladder in urinary infections or malformations.
- Hips, for frequent synovitis or hip dysplasia in the newborn.
We will not continue listing more indications for its use, since those already mentioned are enough to understand the emerging value of ultrasound in the pediatric practice -I bet that every day it will be used more and more by the pediatrician as it is already used by the cardiologist or gynecologist-, and that is why we adopt it for better diagnoses in our Pediatrics and Child Respiratory practice.