Musculoskeletal bleeds in children and young people with bleeding disorders may be clinically occult based on traditional assessment methods. For this reason, there is a growing trend to utilise point-of-care ultrasound as a supplementary tool to enhance physiotherapy clinical decision-making. Case examples will highlight how collaborative practice between physiotherapists and sonographers, and the integration of ultrasound into clinical care, can optimise decision-making and support a safe, individualised return to activity.

Introduction: Neonatal diaphragmatic abnormalities can be challenging to define and have traditionally been detected on either antenatal ultrasound or on routine neonatal chest x-rays. Ultrasound is emerging as a valuable diagnostic tool for these cases and while no cases were previously performed at our facility, we performed 5 cases in 2025 which resulted in improved diagnostic outcomes for patients.
Method: The new scanning technique was developed in consultation with our lead paediatric radiologist following a literature review and adaption of the technique used on adults. Both hemidiaphragms were assessed with B-mode to assess any defects in the contour. M-Mode was also used to assess the movement (excursion) of the diaphragm bilaterally.
Results: Two of the neonates had findings suspicious for diaphragmatic eventration.
One had suspicious lucencies within the chest which required additional investigation to exclude a congenital diaphragmatic hernia. Two cases were sonographically normal/equivocal.
Conclusion: The neonatal diaphragm can be assessed by ultrasound for a range of indications and is a valuable tool where other modalities may not be appropriate. Although this is a new technique for our workplace, these cases have started a foundation and systematic approach for any future examinations.
Take home message; Ultrasound techniques are constantly evolving and can be effectively applied to a variety of exams which are less traditional, especially in the paediatric field.