Point-of-care lung ultrasound in primary care is feasible and useful for investigating suspected community-acquired pneumonia (CAP), according to a study published in Annals of Family Medicine. Researchers investigated whether lung ultrasound performed in primary care is useful and feasible for diagnosing CAP when compared with chest radiography. The analysis included patients aged 5 and older treated by family physicians and primary care pediatricians at 12 primary care centers. Positive lung ultrasound findings (consolidation measuring >1 cm or a focal/ asymmetrical B-lines pattern) showed a sensitivity of 87.8%, a specificity of 58.5%, a positive likelihood ratio of 2.12, and a negative likelihood ratio of 0.21 compared with chest radiography. Regardless of physicians’ previous ultrasound training or experience, findings were similar. Lung ultrasound was generally performed in 10 minutes or less. “We propose a practical algorithm whereby patients having consolidation measuring greater than 1 cm or normal findings on lung ultrasound could skip chest radiography, whereas patients with a B-lines pattern without consolidation (given its low specificity) would need chest radiography to ensure appropriate management,” the authors wrote.
