How can you become an internationally acclaimed ultrasound specialist? An excellent imaging ability as well as a skilled eye and a vast medical background aren’t enough. Here are some important suggestions to aid you in your journey and become a true expert of ultrasound.
1.) Be aware of what you’re looking for.
Imagine dropping the bag full of products. Wouldn’t you like to find out what was in the bag first? This is also true for ultrasound. It is essential to take an “complete” examination. But, honestly, should you always pay attention to every aspect of our heart even if we’re not looking for something particular?
For instance, it’s easy to overlook this small fibroelastoma when you don’t be aware that the patient experienced cerebrovascular events:
My suggestion isto Talk to your patients, ask for more information from your doctor who refers them, then read their medical records and study studies from other imaging modality.
2) Observe-describe-interpret
We are often prone to draw conclusions too quickly. We may see a disease and think that we know what’s happening. But take care: statistics’ laws state that even the most unlikely events must be seen occasionally.
Here’s an example of this Here’s an example: We discovered a massive mass of pulmonary artery of a patient with deep vein thrombosis chronic hypertension of the pulmonary system and right-sided over-pressure in the heart.
You could say that it’s a thrombus is that right? It’s not so sure. It was later discovered as a tumor called rhabdomyosarcoma which was growing in the pulmonary arterial.
My suggestion: first observe and then give a thorough description (size or location, echogenicity, etc.).) and then make your own interpretation. However, you must also give possible alternative diagnosis. So, you’ll never get completely off track.
3.) Don’t be afraid to be unsure
The interpretation of ultrasound findings is generally not a straightforward black and white matter. Keep in mind that “eyeballing” is a crucial part in ultrasound “is the appearance of the organ normal , or is it an organ with a tumor that is hidden within?” “Is mitral regurgitation moderate or mild?” “What about regional wall motion anomalies?” And most importantly “how do you determine “the” left ventricle functioning?”
Recently, I shared the following picture of the four chambers to Facebook and asked our friends to comment on how they would view the left ventricular function of this patient.
The comments varied from normal to extremely diminished. What’s my opinion? Sincere, I’m not certain either. I would suggest it’s likely to be in the area of moderately reduced. The ventricle is exhibiting this abnormal motionthat makes it difficult to determine the cause. This will be exactly the way I’d write within the document. It could read as follows: “Difficult interpretation of LVF due to an abnormal septal movement possibly moderately reduced LVF.
Do not be scared of words like “probably”, “could be”, “might be”, “unclear” or “it appears”. I believe these words are significant because they convey an amount of uncertainty. They may eventually help to increase confidence between yourself and your doctors who refer you to them. Why? Because they prove that you’re honest.
4.) Ask other people
I often do this Everybody needs an opinion from a different perspective – or even help. This is because it’s the ability to rely on “collective intelligence” that has led to the rapid advancements in the field of science. It is a good idea to make use of it more often in the field of ultrasound. Here’s an example Are you aware of what the off-axis subcostal views show?
I wasn’t aware of it until a few years ago, until I presented the examination to a colleague in radiology. He gave me a detailed explanation of the symptoms that are characteristic of Polycystic Syndrome. This is exactly what this patient was suffering from. The lesson hereis to ask other people for help and your skills will grow, your work will improve and your coworkers will trust you.
I am aware that it can be sometimes difficult to locate someone to mentor you. Even if there isn’t anyone who can help you, there is the Internet to find numerous forums where you can post your problems, concerns and much more.
5.) Follow up with your patients
Have you encountered this situation? You encounter a patient who has odd pathology and are uncertain of what it is. You report it on your report, and then the patient goes home then goes home. You’ve completed your work, but after a few hours, or perhaps a day or two, you’ve forgot about the patient.
One of the biggest errors I observe among the trainees is that they don’t monitor their patients. They aren’t interested in discover what transpired out of them or what the anomaly they observed was. A tumor? Vegetation? Perhaps perhaps a the thrombus? Was the operation carried out smoothly? What were the results of autopsy? What was the outcome of the autopsy?
Sometimes, it is simple to determine the cause. Bring the patient in for a follow-up test. Here’s an instance of a patient with severe mitral regurgitation and high pulmonary pressure and I was trying to figure out what his” LVF truly was before surgery (left).After the MV repair (right) the pressure in the pulmonary artery fell dramatically (no “D ventricle shaped” no longer) however, it is evident that the LVF is deteriorating. This indicates that we weren’t aware that Left Ventricular Dysfunction was present prior to the surgery. A lower afterload as well as the D ventricle’s shape hindered us from identifying the problem prior to surgery.
Here’s my suggestion Create an inventory of patients you must follow-up with. Set aside a few minutes towards the close of the week to look over the list. Examine the results for your clients. Play the role of a detective to stop your “loop that is learning”.
