Point-of-care ultrasound (POCUS) is a bedside imaging modality that allows physicians to integrate real time imaging data alongside clinical symptoms and laboratory findings to assist with rapid diagnosis and management. In recent years, advancements in portable ultrasound technology and improved accessibility have facilitated its incorporation into primary care settings, particularly within family medicine training programs in Taiwan and the United States. <p> This article explores the application of POCUS in evaluating renal colic, focusing on its utility in detecting urinary stones and assessing hydronephrosis to guide decisions regarding further imaging or specialist referral. <p> While non-contrast computed tomography (NCCT) remains the gold standard for diagnosing urinary stones, POCUS offers significant advantages in identifying large stones, assessing obstruction severity, and determining the need for timely intervention, making it a valuable tool for initial assessment. <p> The STONE-PLUS clinical pathway integrates the STONE score with ultrasound findings of hydronephrosis to stratify patients into low-, moderate-, and high-risk groups. With enhanced diagnostic accuracy, this model helps reduce unnecessary CT scans, particularly in low-risk patients without hydronephrosis. <p> Thanks to its real-time immediacy, portability, and cost-effectiveness, POCUS has the potential to improve diagnostic accuracy and guide clinical decision-making for renal colic patients in primary care. However, further education and systematic training will be critical in addressing barriers such as operator skill gaps and resource limitations, thereby ensuring broader adoption of POCUS as a routine diagnostic tool in primary care.
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