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The advantages of using the ultrasound machine in medicine

Advances and utility of diagnostic ultrasound in musculoskeletal medicine

No ionising radiation Portability, facilitated by laptop sized ultrasound machines. Simplicity, although initially US may be intimidating the common blocks e. Using US the nerve itself can be imaged Linear probe placed in middle of forearm in transverse plane, median nerve circled in red.

  • Not only nerves can be visualised but important fascial planes can be identified e;
  • Over time US machines have become more sophisticated, some of these machines use the returning second degree harmonic of the original frequency to produce an improved image;
  • Ultrasound scanning is also a good method of examining the body's internal organs, including the heart, liver, gallbladder, spleen, pancreas, kidneys and bladder;
  • Ultrasound techniques require improved anatomical knowledge and a formal educational program;
  • What are the disadvantages of US?

In this image the linear probe is placed in a longitudinal plane over the upper part of the posterior aspect of the thigh. The nerve is seen as a band in the middle of the screen, marked by the blue arrow.

Not only nerves can be visualised but important fascial planes can be identified e. The white arrow indicates bowel, the red arrow indicates the correct plane in which the local anaesthetic is able to peel the muscle off the posterior rectus sheath.

European Society for Paediatric Anaesthesiology

Complications from surrounding structures can be avoided, in neonates in particular vulnerable structures are very close to the areas we wish to insert our needle. Linear probe positioned parallel and posterior to the clavicle, note the subclavian artery highlighted by Doppler anterior to the supraclavicular brachial plexus, and the pleura indicated by the red arrows.

Linear probe placed transverse over the abdomen of a neonate just caudad of the umbilicus. The aorta and inferior venae cava are highlighted by Doppler.

  1. Ultrasound scans help in determining the sources of pain, swelling or infection a patient may suffer from.
  2. Bone blocks US waves. By repeatedly changing the angle of the US beam the US filters out a lot of artefacts.
  3. Since the Ultrasound images are captured in real time, they demonstrate movement of internal tissues and organs, and allow physicians to observe the patient's blood flow and heart valve functions. Complications from surrounding structures can be avoided, in neonates in particular vulnerable structures are very close to the areas we wish to insert our needle.
  4. Not only nerves can be visualised but important fascial planes can be identified e.
  5. Ultrasound scanning is also a good method of examining the body's internal organs, including the heart, liver, gallbladder, spleen, pancreas, kidneys and bladder.

The rectus muscle itself is only 2mm thick green arrowsdeep to it lie the abdominal contents. By performing a mapping or scout scan the operator creates a 3-D image of the anatomy so best needle approach can be selected. Real time guidance allows fine needle control and the ability to observe the local anaesthetic injectate actually spreading. There is evidence for faster onset and greater duration of blockade.

Benefits Of Ultrasound Scans

Blocks can reliably be performed in the presence of neuromuscular conditions or neuromuscular blockade. Peripheral nerve catheter tip position can be assessed directly or indirectly by observing the injection of saline.

  1. Most Ultrasound examinations take forty five minutes or less. Using US the nerve itself can be imaged Linear probe placed in middle of forearm in transverse plane, median nerve circled in red.
  2. Increased depth means a lower frequency is required for optimal imaging. Linear probe placed on posterior aspect of lower thigh, common peroneal and tibial nerves indicated by red arrows, catheter tip indicated by green arrow.
  3. Not only nerves can be visualised but important fascial planes can be identified e. Ultrasound images will often demonstrate movement, function and anatomy, and will allow radiologists to analyze a multiplicity of conditions and assess damage after an injury or illness.
  4. The aorta and inferior venae cava are highlighted by Doppler. This is the part of the Ultrasound scanner that is placed on top of the area of the body that needs to be scanned; the respective area will be lubricated with a special gel.
  5. When the Ultrasound scanner's transducer is pressed against the skin, it starts directing a stream of muted and high frequency sound waves into the body. Generally children are smaller so their nerves are very superficial; this allows higher frequency probes to be used.

Linear probe placed on posterior aspect of lower thigh, common peroneal and tibial nerves indicated by red arrows, catheter tip indicated by green arrow. Most paediatric blocks are performed under general anaesthesia — this has the potential to mask warning symptoms and signs of LA toxicity and intraneural injection.

  • When the Ultrasound scanner's transducer is pressed against the skin, it starts directing a stream of muted and high frequency sound waves into the body;
  • The structures most commonly imaged with diagnostic musculoskeletal US, include tendon, muscle, nerve, joint, and some osseous pathology;
  • Ultrasound pictures work on exactly the same basis as the sonar that bats and submarines use to navigate;
  • The structures most commonly imaged with diagnostic musculoskeletal US, include tendon, muscle, nerve, joint, and some osseous pathology.

Generally children are smaller so their nerves are very superficial; this allows higher frequency probes to be used. Ossification is complete by approximately 21 years of age. At birth the ossification centres of the spine are at an early stage of development; it is therefore possible to obtain excellent spinal images in neonates. With age the US windows to the spine diminish.

Advantages and disadvantages of diagnostic US

The anatomy of the very young is poorly described as are the techniques associated. Congenital abnormalities make landmark techniques difficult to perform. And flexion deformities can prevent peripheral nerve stimulation being effective. What are the disadvantages of US?

  • Most paediatric blocks are performed under general anaesthesia — this has the potential to mask warning symptoms and signs of LA toxicity and intraneural injection;
  • Diagnostic US also can examine large areas with extended field of view FOV imaging, however the clinician can interact with the patient who can then direct the examination toward the symptomatic area [ 3 ] Fig;
  • The transducer is the small gadget that the Ultrasound technician will hold in his or her hand and that is attached to the scanner;
  • This occurs with nerves, tendons and needles.

Increased depth means a lower frequency is required for optimal imaging. As a consequence there is a lower resolution. Over time US machines have become more sophisticated, some of these machines use the returning second degree harmonic of the original frequency to produce an improved image. Simply this means a structure is highly reflective to ultrasound.

Ultrasound Pros and Cons

This occurs with nerves, tendons and needles. Manufacturers now have a specific program to enhance the needle image.

Bone blocks US waves. As such imaging of the spine is increasingly difficult with increasing age. If a structure can only be seen in one plane it is likely to be an artefact. Manufacturers have tried to make life easier with multi-beam technology. By repeatedly changing the angle of the US beam the US filters out a lot of artefacts.

Ultrasound techniques require improved anatomical knowledge and a formal educational program.