Clinical significance of sonographic findings in outpatient clinics

In the literature substantial controversy exists about the clinical significance of abdominal screening procedures. Therefore, the aim of our prospective study was to determine the clinical relevance and the differences of sonographic findings in both symptomatic and asymptomatic screening outpatients. We therefore systematically analyzed the sonographic findings in 200 consecutive patients of a medical outpatient unit. The patients were divided into 2 subgroups: group I consisted of 128 patients without specific clinical symptoms in the abdomen (screening group); group II included 72 patients with abdominal symptoms and therefore well-defined sonographic requests. The consequences drawn from the sonographic results were analyzed separately for both patient groups. All findings were subdivided into relevant, prospectively relevant or not relevant, depending on their individual influence on the patients' course. In all cases the entire abdomen and basal parts of the thorax were examined. In the 1st group (n = 128/93 findings) 6 findings (6.5%) were relevant, 24 (26%) prospectively relevant and 63 not relevant (67.5%). In contrast, the 2nd group (n = 72/68 findings) contained 13 relevant (19%), 27 prospectively relevant (40%) and 28 not relevant sonographic findings (41%). The differences between group I and II were statistically significant for the relevant findings (2p < 0.05) and the not relevant findings (2p < 0.01). In conclusion, abdominal ultrasonography provides--even for the screening of the outpatient population--in up to 30% additional clinically acute or prospectively relevant information. Therefore, it completes the physical examination adding a substantial amount of clinical information to the medical record of outpatients.