Preliminary study on diagnosis of acute scrotum using point-of-care ultrasonography by novice emergency residents: a comparison with conventional ultrasonography

Kipum Kim

, Kwanjae Kim

, Changjoo An

, Yeonho Yoo, Seunghwan Kim

Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea

Correspondence

Wonjoon Jeong ,Tel: 042-280-6003, Fax: 042-280-6019, Email: gardenjun@hanmail.net,

Received: July 12, 2019; Revised: September 7, 2019 Accepted: September 18, 2019. Published online: April 30, 2020.

ABSTRACT

Objective:
The diagnostic accuracy of novice residents in evaluating the scrotal pathology by point-of-care (POC) ultrasonography (US) was compared with that by the conventional US to determine the level of experience required to achieve competency.
Method:
Three novice residents underwent a one-day training course on identifying scrotal pathologies using POC US. They performed POC US on patients with an acute scrotum to identify five pathological findings. The diagnosis was confirmed by conventional scrotal US. The sensitivity and specificity of POC US by novice residents were calculated, and the changes in sensitivity and specificity over time were observed.
Results:
Sixty-two patients were included; the overall sensitivity and specificity were 76.7% (95% confidence interval [CI], 61.3%-88.2%) and 78.9% (95% CI, 54.4%-93.9%), respectively. Decreased blood flow in the testicle showed very good specificity (100%; 95% CI, 93.8%-100.0%). The sensitivity and accuracy were variable at first 18 scans of each resident, but increased after 18 scans and were maintained over time.
Conclusion:
Although the diagnostic accuracy of novice residents in evaluating the scrotal pathology using POC US was variable at first, the accuracy improved over time, especially after 18 scans of each resident. Nevertheless, larger, longterm research is needed to confirm the results of this study.

Key words: Ultrasound; Testicular torsion; Epididymitis; Orchitis; Scrotum