Optimise your image..practice those probe skills!
Stuart Wildman, MSK Sonographer and Extended Scope Physiotherapist
The first part of integrating ultrasound into your clinical practice involves the ability to be able to create a high quality ultrasound image. This involves being able to manipulate the probe to optimise the image and to avoid artefacts. Attached is an infographic that describes a number of different probe skill techniques that you can practice.
It is often said to being a similar skill as to that of playing a musical instrument, when you play different keys whilst reading the musical script. In this instance we are manipulating the probe whilst not actually looking at it, as we are interrogating the ultrasound image and instinctively moving the probe to improve the image quality.
Musculoskeletal ultrasound is inherently prone to artefacts such as Anisotropy, due to the complex anatomy that is being viewed and the changing anatomy and relationships of different tissue types. One of the key probe skills techniques is the ability to ‘Fish tail’ to enable visualisation of a linear structure such as a tendon in its entirety. This is discussed further in our protocol for shoulder ultrasound.
The skill of ‘spinning’ the probe from a long axis view to a short axis view is also important, and is encountered in clinical practice when establishing if a finding is present in both a longitudinal and transverse plane.