From Cadavers to Soundwaves: The Evolution of Autopsy in Medical Diagnosis and the Rise of Point-of-Care Ultrasound

TL;DR

This paper examines how point-of-care ultrasound (POCUS) can serve as a modern alternative to traditional autopsies in medical diagnosis.

Contribution

The paper evaluates POCUS as a potential 'bedside autopsy' tool and its role in reducing diagnostic discrepancies.

Findings

POCUS shows high accuracy in detecting major pathologies in critical and emergency care.

POCUS lacks the ability to perform histopathological analysis, limiting its use in determining exact causes of death.

Integrating POCUS into clinical workflows may help bridge diagnostic gaps caused by declining autopsy rates.

Abstract

This article aims to explore how closely point-of-care ultrasound (POCUS) aligns with final diagnoses and whether it could serve as a modern macroscopic alternative to autopsy. To address this question, a comprehensive literature review was conducted, examining the historical decline of autopsy, the influence of evidence-based medicine on diagnostic confidence, and the potential of POCUS to enhance clinical decision-making.

POCUS has demonstrated high accuracy in detecting major pathological conditions, particularly in critical care and emergency settings, and its use has now extended to primary care. However, its role as a "bedside autopsy" remains debated. While POCUS provides real-time, macroscopic assessment, it does not allow for histopathological analysis, limiting its ability to determine the definitive cause of death. Despite these limitations, integrating POCUS into clinical workflows may help reduce diagnostic discrepancies and serve as a practical alternative in settings where traditional autopsy is unavailable or underutilized.

Although POCUS cannot fully replace traditional autopsy, it offers a valuable tool for macroscopic postmortem assessment and may help bridge some of the diagnostic gaps created by declining autopsy rates. Incorporating POCUS findings into clinicopathological conferences and medical education could enhance diagnostic accuracy and reinforce evidence-based clinical practice. Further research is needed to refine its applications in postmortem diagnostics and establish its optimal role in forensic and hospital-based settings.