THE ROLE OF POINT-OF-CARE ULTRASONOGRAPHY BY FAMILY MEDICINE PROVIDERS WITH NURSING SUPPORT IN GUIDING PHYSICAL THERAPY FOR MUSCULOSKELETAL INJURIES: A SYSTEMATIC REVIEW
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Keywords
point-of-care ultrasonography, family medicine, musculoskeletal injuries, nursing support, physical therapy, primary care, interprofessional collaboration.
Abstract
Background: Musculoskeletal (MSK) injuries are among the most common causes of disability and healthcare utilization worldwide. In primary care, effective diagnosis and management of MSK conditions require timely assessment and interdisciplinary collaboration. Point-of-care ultrasonography (POCUS), when used by family medicine providers with the support of trained nursing staff, has emerged as a valuable bedside diagnostic and management tool that can guide early physical therapy interventions. Objective: This systematic review aims to evaluate the role, accuracy, and clinical impact of POCUS performed by family medicine providers—supported by nursing teams—in guiding and optimizing physical therapy for MSK injuries. Methods: A comprehensive search was conducted across PubMed, Scopus, Embase, and Cochrane Library databases for studies published between 2010 and 2025. Eligible studies included randomized controlled trials, observational studies, and reviews assessing POCUS in MSK injury assessment or therapy planning within family medicine or primary care settings. Data extraction focused on diagnostic accuracy, workflow integration, interprofessional collaboration, patient outcomes, and barriers to implementation. Results: Twenty-seven studies met inclusion criteria. Evidence consistently demonstrated that POCUS uses by family physicians, with nursing support for preparation and patient positioning, improved diagnostic accuracy for common MSK conditions such as rotator cuff tears, tendinopathies, joint effusions, and ligament injuries. POCUS-guided physical therapy resulted in faster initiation of rehabilitation, reduced unnecessary imaging referrals by up to 35%, and improved functional recovery metrics. Moreover, interprofessional collaboration enhanced efficiency and patient satisfaction. Key barriers included limited training opportunities, time constraints in busy clinics, and variability in equipment access. Conclusion: POCUS, when integrated into family medicine practice with nursing collaboration, represents a transformative approach to musculoskeletal care. It bridges diagnostic and therapeutic pathways by enabling precise, timely assessments that facilitate targeted physical therapy. Expanding structured POCUS training programs for primary care providers and nurses could enhance care coordination, reduce healthcare costs, and improve outcomes for patients with musculoskeletal injuries.
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