January 20, 2009

US is the future of imaging

Should a hand-carried ultrasound machine become standard equipment for every internist?

I say YES!
I'm very excited by ultrasound.  It's used by dolphins, bats, the navy and OB/GYNs. It is harmless, non-invasive, fast, and it is easily performed at the bedside or in the clinic. It can diagnose a lot of fetal conditions, heart, vascular, joint and GI problems. A doppler can detect pulses and heartbeats that a stethoscope cannot. I want to be well-trained in the use of the US before I start my own practice... I foresee an explosion in its potential uses in the near future.

The only downside is that it is "operator-dependent." What does that mean?  You need to be well-trained and KNOW what the heck you're looking for, how to find it and how to interpret the image you're seeing.

Here's how I read an ultrasound, using some super basic tips I picked up from observing some US exams.

You need to be in a position to simultaneously watch the screen AND the hand of the operator. A lot of people make the mistake of looking at the image on the screen itself and they get totally confused by what they see. A slice of a face may briefly pop into view only to be replaced by a round circle with the dark devil horns in the middle. The observant one would notice that the US operator merely rotated his hand to "slice through" the face to visualize the cross-section of the fetal brain and ventricles.

Imagine the transducer (the probe) as the handle of a spatula and the image on the screen as the face of the spatula underneath.

This simple visualization exercise combined with the subtle spinning, pressing, sliding and tilting of the transducer will help you figure out what's going on.

Want to learn more about the ultrasound machine? Visit: HowStuffWorks "How Ultrasound Works"
Spatula image courtesy of beer_squirrel

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