Point of care ultrasound (POCUS) is the use of ultrasound imaging (UI) technology to assist in the screening, diagnosis and/or treatment of any condition within the registered physiotherapist’s area of expertise and competence.
POCUS must be integrated into the broader physiotherapy management of a condition, supporting any aspect of human movement, performance or function, and can be used at any stage within the pathway of care.
The CSP recognises POCUS as being within the scope of physiotherapy practice of the profession.
Examples include:
- Ultrasound-guided injections
- Visual biofeedback on muscle recruitment during patient assessment or treatment.
- Clinical assessment of lung consolidation within respiratory care
Regulation and training
Several professional associations represent practitioners with an interest in medical ultrasound. The Consortium for the Accreditation of Sonographic Education (CASE) is an organisation that exists to accredit sonography training courses delivered within the UK. The CSP became a member of CASE in 2016. CASE provides comprehensive information relating to Standards for Sonographic Education.
The CSP expects that members practising POCUS as part of physiotherapy practice demonstrate that their education and training map to CASE standards or a CASE equivalent standard, at a bachelor’s or master’s degree level.
Where such programmes don’t exist, members should demonstrate their personal competence using existing CPD frameworks.
Frequently asked questions about POCUS
How do I know if I am acting as a physiotherapist or a sonographer?
Physiotherapists use POCUS based on autonomous practice to inform and/or support the clinical assessment and/or treatment of their patients. They can then use the findings to inform their clinical reasoning and subsequent treatment options. This differs from sonography, whereby the individual professional simply carries out the scan on the request of an assessing clinician.
You must ensure your patients understand that you are a physiotherapist using POCUS as a technology to support your overall physiotherapy management of their condition/presentation.
Can I report images scanned by others?
You must only interpret images which you yourself have scanned from a patient. You should not be asked to interpret images scanned by other professionals.
Do I need to take any additional steps when I become qualified in POCUS?
Where POCUS is used by physiotherapists, its nature and purpose should be broadly outlined within their job description. The activity should also be supported by a robust system of continuing professional development and governance. There should be workplace policies and procedures in place governing the use of POCUS.
What should I do if I find serious pathology that beyond the scope of physiotherapy?
Unknown and/or potentially serious pathology may be identified on a POCUS scan. Therefore, physiotherapists using POCUS should have mechanisms in place to refer patients on to an appropriate medical professional. Where CSP members are working in non-hospital settings such as private practice and/or sports settings, they should ensure that robust onward referral pathways and collaborative MDT working are in place.
How should I store my images?
Where it is possible, images should be integrated with the radiology department's Picture Archiving and Communication System (PACS).
You should follow your local information and governance policy.