Ultrasound is useful for many things beyond the traditional cardiac and abdominal exams. Ultrasound can be used to evaluate muscle lesions, deep subcutaneous or intramuscular mass lesions, chronic draining tracts, the mediastinum, and even some pulmonary lesions. Listed below are some typical as well as some less common uses for ultrasound that can help you get your diagnosis:

|Liver Disease|Renal Disease|Abdominal Ultrasound|Genito-Urinary System
|Endocardiography|Neck Ultrasound|Thorasic Ultrasound|Musculoskeletal Ultrasound|Ultrasound Expense|

Liver Disease: Ultrasound can be used to identify changes associated with hepatic lipidosis, neoplasia, biliary obstruction, gall stones, portosystemic shunts and more:

• Fine Needle Aspiration (FNA) of the liver is common and minimally invasive to assess liver pathology with minimal risk.
• Ultrasound guided liver biopsy is a common procedure that can often get you a definitive diagnosis with relatively low risk.

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Renal Disease: Ultrasound can help identify changes associated with pyelonephritis, ureteral obstruction, neoplasia, polycystic kidney disease, ethylene glycol poisoning, leptospirosis, chronic nephrosis and more.

• Ultrasound guided fine needle aspirated (FNA) can diagnose lymphoma as well as other renal neoplasias.
• Percutaneous pyelocentesis/pyelography, which involves placing a needle into the pelvis of a dialated kidney, can be used to sample urine directly for a culture, and/or to inject contract to identify the location of a suspected obstruction.
• Ultrasounds can be used to identify and characterize bladder stones and sometimes even ureteral stones.
• Ultrasonic exams can identify characteristic changes in ectopic ureters.

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Abdominal Ultrasounds:

• Ultrasonic examination of the adrenal gland can help identify masses in you Cushing's suspects. It will also evaluate for vessel invasion.
• GI Ultrasound: Rule out intestinal masses, foreign body obstructions, and linear foreign bodies. Ultrasound can also help diagnose GI perforations, infiltrative diseases of the intestine such as lymphoma and salmon poisoning, and find intestinal infarction and ileus.
• Use fine needle aspiration of enlarged abdominal lymph nodes to discriminate lymphoma or mast cell disease form inflammatory diseases. It also can be used to diagnose nodal metastases of other tumors.
• Rule out infarction or torsion of the spleen, identify splenic changes associated with neoplastic infiltration, hematoma and systemic infections (e.g. rickettsia).
• Ultrasound also be used to identify thrombus in the aorta, vena cava, portal vein or the the primary branches of these vessels.

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Diseases of the Genito-Urinary system: Ultrasound can be helpful in identifying and evaluating pyometra, endometritis, ovarian tumors, prostatic disease and non-palpable testicular tumors.

• Differentiate prostatic hyperplasia from neoplasia with sonographic evaluation and fine needle aspiration or biopsy.
• Identify Paraprostatic cysts and prostatic abscesses.
• Diagnose causes of hematuria; tumors of the bladder vs. cystitis, stones or prostate disease.
• Rule out trigone or urethral involvement of bladder masses.

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Echocardiography: Use an ultrasonic exam to evaluate congenital heart disease, chronic valvular disease, endocarditis, DCM, HCM, pericardial effusion, etc.

• Drain pericardial effusions with US guidance.
• Evaluate for pulmonary hypertension in some cases.
• Determine if myocardial failure is present.
• Ultrasound can even be used to determine vascularity and extent of invasion of masses in the neck or inguinal area!

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Neck Ultrasound:

• Evaluate the larynx for invasive non-palpable masses.
• Assisted in diagnosis of laryngeal paralysis.
• Evaluate thyroid glands for evidence of enlargement, atrophy, or neoplasia.
• Evaluate parathyroid glands for enlargement in hypercalcemia.

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Thoracic Ultrasound: Evaluate mediastinal and pulmonary masses, sampling and drainage of pleural effusion.

• Mediastinal masses can usually be sampled.
• pulmonary masses can be visualized and sampled if they are peripheral enough to be near the pleural surface of the lung.
• Diagnose diaphragmatic hernias.

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Musculoskeletal Ultrasound:

• Chronic shoulder lameness: Diagnose bicipital bursitis, tenosynovitis of the biceps, supraspinatus or infraspinatus tendons.
• Find brachial plexus tumors.
• Use ultrasounds guidance to evaluate and sample bone tumors; obtain an diagnostic FNA instead of doing a bone biopsy.
• Follow a draining tract to see where it leads, and sometimes even find the foreign body causing the drainage.
• Evaluate muscle/limb swellings for the presence of an underlying mass or abscess.
• Diagnose hydrocephalus with ultrasound by scanning the brain through and open fontanelle.

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Is Ultrasound Expensive?

Practically speaking, ultrasound usually saves money. Recruiting a specialist like Dr. Jones to perform these diagnostics in your clinic provides high quality medicine and more accurately directed patient workups and therapy. The volume of information quickly gained from a thorough ultrasound exam can rule out many disease processes at once, narrowing your list of differentials and avoiding "wild goose chases." In the end, you will usually get your diagnosis faster with less overall expense. Your clients can only get happier by being offered more accurate diagnostic services!