Today’s medical professionals have access to a variety of imaging procedures. Ultrasound is one of the more convenient methods as it doesn’t require exposing patients to radiation and provides relative freedom in movement. Because of this added safety, sonography is a preferred method for monitoring pregnancy and majorly contributed to recent developments in obstetrics. Nonetheless, obstetricians don’t have a monopoly on this expanding technology. Here are 5 other areas where its adoption proved useful:
1: Cardiology and Acute Care
Cardiovascular ultrasound provides physicians with a valuable look inside of the chest cavity as well as a look at vasculature throughout the body. Cardiac ultrasounds, or echocardiograms, produce images of heart anatomy such as valves, chambers and shed light on any abnormalities that may be present when investigating heart function. Vascular ultrasound is used to evaluate blood flow and detect blockages as well as blood clots. This is especially helpful for following up and monitoring recent recipients of stents or grafts. Echocardiograms are traditionally interpreted by a cardiologist. Recently however, the use of limited echocardiography by providers such as anesthesiologists and emergency medicine physicians is becoming more common 1 . These point of care echocardiograms are utilized by non-cardiologists along with thoracic ultrasonography to evaluate for cardiac trauma, hypotension, pneumothorax and alveolar/interstitial diseases that can lead to respiratory failure 2 . Though it cannot replace a comprehensive exam, ultrasound delivers vital supplementary information for monitoring patients and establishing diagnosis in an acute setting.
In situations where a standalone PET, MRI or CT scan doesn’t afford enough scope, radiologists take advantage of an innovative technique that incorporates ultrasound to gather more data. Fusion imaging is the process in which images from the above scans are overlaid or used side by side with ultrasound images. Newer high-end software is even capable of fusing scans with live ultrasound 3 . This is advantageous for both physicians and patients because tissues can be viewed in real time and compared to findings from multiple modalities. Sonography is also a more convenient option for real time scanning compared to MRI as there’s no need to factor in things like contrast injections or worry about metal implants. With applications ranging from brain surgery and liver procedures to ultrasound guided tumor removal 3 , fusion imaging is gaining momentum in the diagnostic world.
3: Musculoskeletal Imaging
Another useful trait of sonography is that it’s the most sensitive imaging technique for assessing the extent of tendon tears 4 . This is particularly helpful in sports medicine as well as podiatry, where clinicians frequently need to evaluate injury sites and differentiate between inflammation and actual tears. Other key applications include evaluating conditions such as plantar fasciitis and determining whether an athlete has merely suffered from a muscle strain or a full on avulsion fracture 4 . In addition to visualizing muscle tissue, joints, fascia and tendons, musculoskeletal sonography assists in outlining bones. Although ultrasonic waves do not penetrate bones, they can still image features on the surface. Research even suggests that ultrasound is a feasible method for diagnosing stress fractures, particularly in the lower extremities 5 . An added trait of newer ultrasound is that more portable technologies allow evaluations to take place out of the clinic as well as assessing the function of moving parts while in use as opposed to being limited to static images.
Ultrasound is employed by dermatologists to evaluate skin conditions and adjust treatment plans. Cost is factor that inhibits dermatologists from adopting new imaging methodologies because advanced techniques such as reflectance confocal microscopy and optical coherence tomography require expensive computing systems as well as training 7 . When extreme detail isn’t necessary, skin ultrasonography serves as an economic, reliable solution for rapid examination and measurements. High frequency scanners are able to monitor detectable, irregular properties in the dermis while lower frequencies detect deeper structures such as lymph nodes and subcutaneous tumors 6 . Given these capabilities, sonography is a cost-saver for identifying inflammatory conditions such as psoriasis or looking at skin lesions and tumor thickness.
5: Handheld, Bedside Ultrasound
This final application utilizes multiple modalities. The adoption of diagnostic ultrasound is growing in the rural and developing world, and in particular, handheld, bedside ultrasound performed by clinicians 8 . This is a simple and elegant solution in regions where more expensive systems and infrastructure are difficult to access. Portable devices with abdominal, cardiac and musculoskeletal capabilities among others are making a difference where medical imaging may not have been an option previously. Sonography provides a basic diagnostic tool for a number of ailments in low and middle income countries such as tuberculosis, malaria, and ectopic pregnancy 8 . Medical professionals worldwide have taken advantage of the technology and are making a statistical impact by administering obstetrical, abdominal, cardiac, renal, pulmonary, soft tissue and vascular exams in rural areas of Africa, Asia and North America 8 . Diagnostic ultrasound is a powerful mechanism with functionality in all areas of medicine. With varying frequencies and modes, physicians from different backgrounds utilize sonography to image conditions spanning from the most superficial of ailments all the way to organ trauma and tumor identification. Its diverse capabilities and relative cost make it a tool worth having available.
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