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Background <p>Point-of-care ultrasonography (POCUS) has emerged as a bedside diagnostic imaging modality capable of providing real-time structural and functional assessment; however, its role within internal medicine wards remains incompletely defined from a diagnostic imaging perspective.</p> Aim of the work <p>This systematic review aimed to evaluate the diagnostic and clinical impact of POCUS in internal medicine ward settings, with emphasis on diagnostic refinement, detection of additional clinically relevant findings, downstream imaging utilization, and modification of management strategies.</p> Methods <p>A systematic search of MEDLINE, Embase, and Scopus was conducted from inception through January 31, 2026. Studies evaluating bedside ultrasonography performed in internal medicine wards and reporting diagnostic or clinical impact outcomes were included. Eight studies comprising 2111 hospitalized patients met the eligibility criteria.</p> Results <p>Across included studies, POCUS was associated with refinement of the working diagnosis in approximately 18–37% of clinical encounters and management modification in 20–52% of patients. Ultrasonographic assessment consistently identified additional clinically relevant findings—most commonly pleural effusion, ventricular dysfunction, pericardial effusion, and abnormalities in intravascular volume status—frequently not detected by standard clinical examination. Several studies reported reductions in downstream imaging utilization, while selected reports indicated shorter hospital length of stay. Mortality outcomes were inconsistently reported and were not primary endpoints.</p> Conclusions <p>The available evidence suggests that POCUS may be a valuable adjunct to bedside assessment in internal medicine wards. Its integration into routine clinical practice appears to be associated with earlier diagnostic clarification, more informed patient management, and reduced reliance on additional imaging in selected clinical settings. However, because the current evidence is derived predominantly from observational studies, these findings should be interpreted with appropriate caution. Further high-quality prospective multicenter studies are needed to better define the impact of POCUS on patient outcomes, healthcare resource utilization, and standardized implementation within diagnostic imaging pathways.</p>

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Diagnostic and clinical impact of point-of-care ultrasonography in internal medicine wards: a systematic review of its role in imaging-guided decision-making

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Mohamed Ali Mansour,
  • Mohamed Ezzat Ibrahim Hussein,
  • Mohamed Shawky Al-Didamony Tantawy Foda

摘要

Background

Point-of-care ultrasonography (POCUS) has emerged as a bedside diagnostic imaging modality capable of providing real-time structural and functional assessment; however, its role within internal medicine wards remains incompletely defined from a diagnostic imaging perspective.

Aim of the work

This systematic review aimed to evaluate the diagnostic and clinical impact of POCUS in internal medicine ward settings, with emphasis on diagnostic refinement, detection of additional clinically relevant findings, downstream imaging utilization, and modification of management strategies.

Methods

A systematic search of MEDLINE, Embase, and Scopus was conducted from inception through January 31, 2026. Studies evaluating bedside ultrasonography performed in internal medicine wards and reporting diagnostic or clinical impact outcomes were included. Eight studies comprising 2111 hospitalized patients met the eligibility criteria.

Results

Across included studies, POCUS was associated with refinement of the working diagnosis in approximately 18–37% of clinical encounters and management modification in 20–52% of patients. Ultrasonographic assessment consistently identified additional clinically relevant findings—most commonly pleural effusion, ventricular dysfunction, pericardial effusion, and abnormalities in intravascular volume status—frequently not detected by standard clinical examination. Several studies reported reductions in downstream imaging utilization, while selected reports indicated shorter hospital length of stay. Mortality outcomes were inconsistently reported and were not primary endpoints.

Conclusions

The available evidence suggests that POCUS may be a valuable adjunct to bedside assessment in internal medicine wards. Its integration into routine clinical practice appears to be associated with earlier diagnostic clarification, more informed patient management, and reduced reliance on additional imaging in selected clinical settings. However, because the current evidence is derived predominantly from observational studies, these findings should be interpreted with appropriate caution. Further high-quality prospective multicenter studies are needed to better define the impact of POCUS on patient outcomes, healthcare resource utilization, and standardized implementation within diagnostic imaging pathways.