Mother Knows Best: Handheld Ultrasound Helped This Doctor Catch Her Son’s Disease Early

Like many clinicians, Dr. Leigh Ann Cashwell finds herself providing care for her own family from time to time in her small hometown in Mississippi. A few years ago, the mother of three boys was examining her 15-year-old son, Luke, with a handheld ultrasound system from GE called Vscan Extend when she came across something unexpected. “I was scanning his neck, and when I got to his thyroid, I immediately knew that there was nothing normal about what I was looking at,” said Cashwell. “The thyroid was enlarged and heterogenous with multiple small nodules throughout. I was speechless.”

Working as a diagnostic radiologist at George Regional Hospital in Lucedale, Mississippi, Cashwell called to see if she could get Luke in that evening for a follow-up ultrasound scan on the hospital’s larger ultrasound unit often used for in-depth scans. Thankfully, the ultrasound technologist was still at the office. “The image on the larger ultrasound unit looked just like it did on the Vscan Extend,” Cashwell remembers. “We sent the scan to my partner at the hospital and got an appointment set up with his primary care doctor for lab testing that Monday.”

Lab tests confirmed Cashwell’s suspicion. Luke had a thyroid condition known as Hashimoto’s disease, an autoimmune disease in which the body attacks the thyroid, gradually destroying the thyroid tissue. If left untreated, the condition can lead to lifelong hypothyroidism with possible severe complications, including neurologic damage, depression and cardiac complications. Within three days, Luke’s workup was complete, and he was started on treatment for the disease. “This is something Luke will have for his entire life, but if we hadn’t done that scan on the Vscan Extend, who knows how long it would have been before we knew that he had hypothyroidism,” Cashwell said. “It was an absolute blessing that we were able to find this and get it fixed so quickly so he can live a healthy, normal life.”

Like Cashwell, many clinicians have experienced the value of handheld ultrasound in an emergency or primary care environment. Clinical experts report the device, which looks like a smartphone with a cable that links to an ultrasound probe, provides quick information and enables them to see what cannot be easily seen or felt. “Throughout a recent experience with handheld ultrasound I kept thinking to myself, ‘What an advantage it is for primary care doctors to have a technology like this,’” Cashwell said. “Incorporating handheld ultrasound in a typical physical exam could help them quickly see things that could otherwise be missed.”

Many doctors know this. The American Academy of Family Physicians refers to point-of-care ultrasound as the “the biggest advance in bedside diagnosis since the advent of the stethoscope 200 years ago” with the recommendation that family medicine residents in the United States all be proficient in using the imaging technology.

In typical circumstances, handheld ultrasound has provided additional value as an easy-to-use, lightweight and portable ultrasound tool that clinicians can have on hand throughout their day to evaluate and triage patients with pulmonary, cardiac and other diseases. One study found the performance of handheld ultrasound devices comparable to standard ultrasonography for general practices, as well as suggesting an incremental benefit when used in physical examinations.[1]

Outside of primary care, clinicians use handheld ultrasounds throughout the hospital, including in the ICU and the oncology unit.  

The technology has also played a critical role throughout the pandemic, helping clinicians manage the treatment of patients with the virus.  Providers around the world are using this tool to quickly monitor the lungs and heart of COVID-19 patients. Besides being portable and affordable, the technology is also easy to use and disinfect. AI software that can run on the Vscan Extend also allows users to evaluate patients’ hearts for risk of heart failure. “Handheld ultrasound facilitates early and reliable diagnosis,” said Dr. Francis Pellet, general practitioner at Leopold Ollier Medical Station — Les Vans in France. “More globally, it allows for increased confidence by improving clinical evaluation, management, patient follow-up and referral to specialists or in emergencies. Conversely, it can help avoid referring a patient to additional care when ultrasound provides evidence of no increased risk.”

“In the case of the COVID-19, it allowed us to affirm or exclude the presence of clinical indicators of infected patients with the ultrasound’s images and findings.”

[1] Colli A, Prati D, Fraquelli M, Segato S, Vescovi PP, Colombo F, et al. (2015) The Use of a Pocket-Sized Ultrasound Device Improves Physical Examination: Results of an In- and Outpatient Cohort Study. PLoS ONE 10(3): e0122181. doi:10.1371/ journal.pone.0122181