Volume 30, Issue 168, February 2026

Point of Care Ultrasound for Skin and Soft Tissue Abscesses in the ED: Diagnostic Accuracy, Management Strategies, and Clinical Outcomes

Mazi Mohammed Alanazi¹, Ibrahim Abdalmahsn Alresaini², Amjad Mohammed Albanna³

¹Saudi and Jordanian Board Emergency Medicine, Emergency Department, Head of Emergency Research Unit, First Health Cluster, Riyadh, Saudi Arabia
²Saudi Board Emergency Medicine Resident, Emergency Department, National Guard Hospital, Riyadh, Saudi Arabia
³Saudi Board Emergency Medicine Resident, Emergency Department, National Guard Hospital, Riyadh, Saudi Arabia

ABSTRACT

Background: one of the common presentations to emergency department (ED) are skin and soft tissue abscesses. During physical examination cellulitis and drainable collections may be missed which lead to delayed drainage or unnecessary procedures. Methods: We conduct our systematic review of randomized and observational studies according to PRISMA guidelines including adults with suspected skin or soft tissue abscess in emergency departments. Eligible studies evaluated point of care ultrasound (POCUS) for diagnosis, management and reported diagnostic accuracy. We extract data on study design, POCUS protocols, comparators, and treatment failure. Results: we include six studies, all conducted at emergency settings. When POCUS is added to aid in clinical assessment sensitivity increase up to 98% for abscess detection and improved specificity compared with clinical assessment alone. A randomized trial showed higher failure with ultrasound-guided needle aspiration than standard incision and drainage (I&D), whereas another trial showed fewer repeat procedures when I&D was POCUSguided. One of the included studies found POCUS more sensitive than computed tomography for superficial abscess. A cohort study identified abscess depth greater than 0.4 cm on POCUS as strongly associated with failure of antibiotic only treatment without drainage. Conclusion: In emergency patients, POCUS improves diagnostic accuracy, informs the need for drainage, and optimize I&D outcomes and short term clinical outcomes.

Keywords: POCUS; Skin abscess; Soft tissue infection; emergency department; I&D; Diagnostic accuracy

Medical Science, 2026, 30, e26ms3789

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DOI: https://doi.org/10.54905/disssi.v30i168.e26ms3789

Published: 09 February 2026