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Hospital for Special Surgery Radiologist’s Study Supports the Use of Portable Ultrasound in Developing Countries

Paper demonstrates clinical benefits of compact technology at urban and rural sites in Ghana, West Africa

New York—November 28, 2008

Of all the current imaging techniques, portable ultrasound has shown the greatest promise in meeting the needs in developing countries such as Ghana because it is transportable, relatively inexpensive and has a wide range of applications.  This conclusion is based on a study to be published in the December 2008 issue of the Journal of Ultrasound in Medicine.

In many developing countries, access to medical imaging is limited by the availability of economic resources and expertise in performing and interpreting these images, as well as the skilled labor necessary to maintain the equipment. 

In March 2004, Dr. Ronald Adler, chief, Division of Ultrasound and Body CT, Hospital for Special Surgery Department of Radiology and Imaging, explored the use of ultrasound in primary care and hospital settings at the Ghana Health Mission clinic in Sekondi-Takoradi, Ghana, West Africa.  The objective was to evaluate the functionality of a portable ultrasound machine and its clinical usefulness in a variety of physical conditions and across multiple clinical scenarios. Jacqueline K. Spencer, M.D., MPH, director of Primary and Ambulatory Care, VA Boston Healthcare System, was a co-investigator in the study.

Ultrasounds were performed at two primary care sites, one in an urban setting and the other in a rural village, and two hospitals, one regional and the other a local hospital, where referrals were made by clinicians.  The majority of ultrasounds were performed for musculoskeletal complaints with the remainder for obstetrical, pelvic, breast, vascular, abdominal and genitourinary (GU) examinations.

The authors found that in clinic settings, musculoskeletal ultrasound represented 46 percent (16) of the ultrasounds performed and 29 percent (10) of the cases were a combination of abdominal, pelvic and GU ultrasounds.  Whereas in the hospital settings, abdominal, pelvic and GU ultrasounds combined were 56 percent (18) and musculoskeletal was 41 percent (13).  Of the 67 ultrasounds performed, 81 percent (54) were found to be abnormal, 81 percent (54) were considered to add to the clinical diagnosis and 40 percent (27) influenced the outcome of medical care for the patient. 

“It was readily apparent that the small, portable ultrasound units could play an extremely valuable role in developing countries,” said Dr. Adler.  “The challenges to effectively instituting this form of imaging will depend on proper training to ensure the appropriate referral of patients who will clearly benefit from such imaging, adequately trained medical personnel to operate the equipment, interpretation of the images and exploration of collaborative efforts with outside organizations or institutions that can assist with these training needs and financial requirements.”

The economic limitations of many countries often means that the cost of a small portable ultrasound machine remains out of reach, noted Dr. Adler, but they are less expensive than CT scanners and MRIs. The former typically costs $25,000 to $50,000 compared to millions of dollars for the full-sized units.

Editor’s Note:  All examinations were performed using a Logiqbook scanner (GE Medical Systems, Milwaukee, Wisc.) and intermediate linear and/or curved linear phased array transducer.


About HSS | Hospital for Special Surgery
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the eighth consecutive year) and No. 3 in rheumatology by U.S. News & World Report (2017-2018). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In 2017 HSS provided care to 135,000 patients and performed more than 32,000 surgical procedures. People from all 50 U.S. states and 80 countries travelled to receive care at HSS. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The culture of innovation is accelerating at HSS as 130 new idea submissions were made to the Global Innovation Institute in 2017 (almost 3x the submissions in 2015). The HSS Education Institute is the world’s leading provider of education on the topic on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally.


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