A One‐Stop Approach to the Management of Soft Tissue and Degenerative Musculoskeletal Conditions Using Clinic‐Based Ultrasonography

Abstract

One-stop clinics aim at assessment, investigation and initiating treatment in a single hospital visit. They have been proven to be cost-effective and to increase patient satisfaction in various specialties. The aim of this study was to describe the one-stop approach to managing soft tissue and degenerative musculoskeletal conditions using clinic-based musculoskeletal ultrasonography (MSUS). A retrospective case record review was carried out of patients assessed and managed in the musculoskeletal clinic by a musculoskeletal and sports physician over a 10-month period. A total of 1,166 patients were assessed and managed in a total of 155 outpatient clinics. The age range of patients was 19 to 85 years (median age 45 years). The diagnoses included traumatic or overuse tendinopathy, degenerative arthritis, bursitis, acute/chronic sporting injuries and acute/chronic back pain. A total of 1,012 patients (87%) had conditions related to the appendicular system (shoulder girdle, upper limb, pelvic girdle and lower limb) and 154 patients were referred with spinal pain. All patients with appendicular system problems had a definite diagnosis and treatment initiated on the first visit to the clinic. In 658 (65%) patients, a diagnostic ultrasound was deemed an appropriate investigation to improve the accuracy of diagnosis and more than half of them (352 patients) needed ultrasound-guided injections as part of the management of their conditions. A portable GE Healthcare LOGIQe machine with a 10 MHz linear probe and colour Doppler flow imaging was used to perform all scans. No adverse incidents were reported. The use of clinic-based MSUS enables a one-stop approach, reduces repeated hospital appointments and improves quality of care in an outpatient musculoskeletal clinic.