Ultrasound First for Pediatric Patients in an Electrodiagnostic Laboratory.

Abstract

Electrodiagnostic testing is often critical for the diagnosis of neuromuscular disease, but it can be challenging in the pediatric population because of poor tolerance. This study evaluates an ultrasound-first approach as a means of reducing the number of electrodiagnostic tests (nerves stimulated and muscles sampled) in the pediatric population. A retrospective analysis of 21 pediatric patients who underwent ultrasound before electrodiagnostic testing as part of a quality-improvement project was conducted and compared with an age-matched control group of 84 patients. The ultrasound-first group underwent significantly fewer muscle samplings (P = 0.0002) and overall number of electrodiagnostic tests (P = 0.0010) than the control group. The ultrasound-first group also underwent fewer nerve stimulations, which approached statistical significance (P = 0.0600). Using ultrasound first in the electrodiagnostic laboratory in pediatric patients could reduce the number of electrodiagnostic tests needed to arrive at a diagnosis.