Primary Sclerosing Cholangitis: A Case Report Revealing a Missed Opportunity to Use Sonography With Elastography

Primary sclerosing cholangitis (PSC) is a progressive liver disease characterized by inflammation and fibrosis of the bile ducts, leading to bile duct strictures and cholestasis, which can result in liver fibrosis and cirrhosis. This case study explores recent advancements in the diagnosis and management of PSC, emphasizing the challenges faced by health care providers in early diagnosis and the underutilization of sonography with elastography, as a monitoring tool. This case of a 71-year-old woman with symptoms and laboratory abnormalities, indicative of PSC, highlights the role of sonography and magnetic resonance imaging in the diagnostic process. Despite technological advancements, diagnosing PSC remains challenging and is often delayed until later stages. While magnetic resonance cholangiopancreatography (MRCP) is the current standard for surveillance, this case would suggest an increased use of sonography with elastography. It would offer a cost-effective and patient-centered alternative for monitoring disease progression. Further research is needed to establish guidelines for effective sonographic evaluation in PSC, potentially improving early diagnosis and patient outcomes.