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Clinical Applications

Adult

Abdomen
Pain, nausea or emesis, bloating, increased gas, mass, hepatomegaly or splenomegaly, cirrhosis, biliary obstruction, cholecystitis, pancreatic mass and pancreatitis, pulsatile abdominal mass raising suspicion of abdominal aortic aneurysm, hernia, ascites.

Renal/Retroperitoneal
Pain, hematuria, fever, dysuria, urinary tract infection, pyelonephritis, urinary tract obstruction, calculi, elevated BUN/creatinine, masses, perinephric fluid collections, trauma.

Renal Transplant
Obstruction, perinephric fluid collections, Doppler for patency and possible rejection.

Female Pelvis
Pain, amenorrhea, dyspareunia, dysfunctional uterine bleeding, post-menopausal vaginal bleeding, masses, infertility, congenital anomalies, hormonal abnormalities, polycystic ovaries.

First Trimester Pregnancy
Uncertain LMP, vaginal bleeding, cramping, pain, history of prior spontaneous abortion, history of prior molar pregnancy, known uterine anomaly, size and dates, viability.

Obsterical (2nd and 3rd trimester)
Size and dates, fetal growth, estimated fetal weight, amniotic fluid volume, maternal diabetes, hypertension/pre-eclampsia, prior anomalies, maternal vaginal bleeding, cramping, and pain. Evaluate placenta.

Male Pelvis
Pain, mass, fluid collection, bladder.

Prostate/Seminal Vesicles
Best evaluated with endorectal sonography and should usually be correlated with serum PSA, possibly free PSA, and digital rectal exam (DRE). If PSA and DRE are abnormal, would require endorectal biopsy to differentiate between benign prostatic hypertrophy (BPH), prostatitis, or neoplasm.

Scrotum
Pain, palpable lump, infertility, cryptorchidism, trauma, hernia.

Thyroid/soft tissue neck
Palpable lump, thyromegaly, abnormal thyroid function tests, symptoms of hypo/hyperthyroidism and parathyroid disease. Evaluate for lymphadenopathy, and abnormalities of the parotid and submandibular glands including pain, enlargement, obstruction, mass.

Chest
Shortness of breath, dyspnea, pleural effusion, occasionally for rib fracture and osseous rib lesions.

Echocardiography
Shortness of breath, dyspnea, fatigue, murmur, hypertension, coronary artery disease, pericardial effusion, wall motion, ejection fraction, arrhythmia, congestive heart failure, planned chemotherapy with known cardiotoxic agents, tachycardia/bradycardia, mass, thrombus in patients with TIA or CVA.

Soft Tissue
Pain, trauma, mass.

 

Vascular Duplex, Power, and Color Doppler

Carotid
Bruit, TIA/CVA, vertigo/dizziness, hypertension, smoking history, amaurosis fugax, visual disturbances, symptoms of subclavian steal, post-op endarterectomy

Venous Doppler lower and upper extremity
Pain, swelling, increased skin temperature, positive Homan’s sign, suspected deep venous thrombosis, popliteal (Baker’s) cyst, superficial thrombophlebitis, lymphadenopathy

Arterial Doppler lower and upper extremity
Pain, claudication, cyanosis, Raynaud disease, diabetes, cold skin temperature, erythema.

Renal artery Doppler
Hypertension, suspected renal artery stenosis

Abdominal Doppler
Post prandial pain, suspected superior mesenteric artery stenosis, cirrohsis, hepatomegaly, splenomegaly.

 

Pediatric

Abdomen
Increased abdominal girth; palpable mass or possible mass by other imaging (i.e., abdominal radiograph); projectile emesis with palpable “olive” suspicious for hypertrophic pyloric stenosis; abdominal pain; intussusception; appendicitis or appendicolith; hepatomegaly; splenomegaly; biliary stasis, obstruction, calculi or cholecystitis; pancreatitis; ascites; hernia; trauma.

Echoencephalography
Neonatal and infant evaluation for hydrocephalus, head circumpherence greater than expected for age, congenital anomalies. Procedure applicable to 6 months age, occasionally up to 8 months possible. After 6 months suggest computed tomography or magnetic resonance imaging.

Renal/retroperitoneal
Pain, hematuria, fever, dysuria, urinary tract infection, pyelonephritis, urinary tract obstruction, calculi, congenital anomalies, masses, trauma.

Chest
Pleural effusion or chylothorax

Pelvis
Pain, congenital anomalies, free fluid, urinary bladder and cystic and solid masses.

Females
Uterus and adnexa/ovaries, possible ovarian torsion.

Scrotum
Pain, trauma, mass, hydrocele, orchitis or epididymis, cryptorchidism, hernia, possible torsion.

Thyroid
Masses, laboratory abnormalities

Soft Tissue
Pain, cystic or solid masses, inflammatory processes/abcess, trauma.

Hips
Developmental hip dysplasia, effusion, ligament laxity.

Echocardiography
Congenital abnormalities, pain, dyspnea, arrhythmia, tachycardia, pericardial effusion, fatigue, murmur, hypertension.