The most important points to remember in handling the probe are these:

  • Use plenty of gel.
  • Be sure to apply sufficient pressure.
  • Keep the probe moving (don’t just slap it on there and hope you’re in the right spot).
  • Always be adjusting the angle of the probe until you find just the right angle (you want to be at a perfect 90-degree angle to whatever structure you are imaging).
A few additional tips:
  • Focus on the anatomy … really think about what you’re looking at and the angle at which it should lie with relation to the surface of the probe. Think of the ultrasound beam as “slicing” through the patient’s foot, giving you an image of what lies directly below the probe. Move the patient’s foot or ankle to see known anatomical structures move. All of this is part of learning to “see in ultrasound,” and at some point things simply begin to click.
  • Generally keep the probe oriented with the little dot to your left (so that everything on your left is on the left side of the screen). Two common exceptions: First, in scanning the plantar fascia, where you will scan longitudinally, coming up over the calcaneous, with the dot-end of the probe pointed distal toward the toes. Second, in scanning the Achilles tendon, where you will usually scan longitudinally along the back of the heel, with the dot-end of the probe pointed toward the patient’s head.
  • If you’re scanning the ankle or looking for anything especially superficial, try using a stand-off. This not only allows you to better navigate the uneven, knobby surface of the ankle, but will also have a substantial impact on your imaging results, by moving the region of interest a little lower on the screen, reducing near-field artifacts, and placing everything into a better plane of focus.
  • Remember that each part of the anatomy, or each pathology, might entail a small learning curve in and of itself. As you go through a number of similar instances, you will begin making clearer and clearer distinctions, and pretty soon it will become part of your working repertoire. It just takes practice.
Split-Screen Technique (for Comparisons & Extensions) …

Just because your probe is only 38mm or 50mm long, doesn’t mean that your image can only extend that length and no further. Your ultrasound has a “split-screen” function, allowing you to either show a comparison of one foot versus the other in one image (or a longitudinal versus transverse image of the same foot, side by side in one image), or to create an extension — where you essentially connect two probe-lengths into one image on the screen (making your normal 38mm image now 76mm, or your normal 50mm image now 100mm in length). You can learn how to execute these techniques by clicking here.

On Proper Probe Care …

I’ve prepared a separate page especially covering proper probe care. You can view this (and share it with your nurses and assistants) by clicking here.