Spring, 2013

Spring, 2013

Hello fellow sonographers! I want to thank everyone who attended our 32nd Annual Spring Symposium at the Grove Park Inn in Asheville. We had over 250 attendees, exhibitors and speakers in the mountains of western North Carolina. The meeting was a great success with excellent reviews for our speakers. Thanks also goes to our immediate past president, Diana Strickland, for putting together this great meeting and Laura Curry, from our central office for all her work behind the scenes. I hope you are taking what you learned and using it in your everyday practice. That’s one of the main purposes of the society. If you missed a session or want to review what was discussed, all the slides from the talks are available on our website at ncus.org in the documentation section. Also check out our Facebook page for more than 90 photos from the meeting.

Here is a list of all our winners:
  • Quiz Bowl General – Cortical Defects from Asheville Buncombe Technical Community College- Ana Pierson, Marian Catlin, Christian Cinnamon
  • Quiz Bowl Echo – The Ischemiacs from Caldwell Community College and Technical Institute-Dustin Drennen and Don Eichmiller
  • Scientific Exhibit General/OB Winner
    • First Place – Ashley Grissom from Pitt Community College “Twin-to-Twin Transfusion”
    • Second Place –Chuu Mong from Johnston Community College “Uterus: Bicorunate vs Unicornuate”
    • Third Place – Kendall Wilson and Kindra Manning from Southwestern Community College “Nuchal Translucency”
  • Scientific Exhibit Echo/Vascular Winner
    • First Place – Malina Peach from Johnston Community College “Endocardial Cushion Defects”
    • Second Place – Taylor Pope from Johnston Community College, “Heart Valves”
    • Third Place – Jeanne Gentry from Pitt Community College “Ventricular Assist Devices”
  • 2013 Sonographer Excellence Award went to Jenny Epperly, RDMS
  • 50/50 raffles –
    • Friday winner was Jennifer Margeney $40
    • Saturday winner was Sylvia Montgomery $200
Mark your calendars for Saturday, October 19th for the Fall meeting at the Friday Center in Chapel Hill. We are getting some great speakers for this meeting. The next spring meeting will be in Raleigh at the Sheraton Imperial RTP on April 11-14. Check the website or our Facebook page for updates and registration information.

The NCUS is YOUR society, so become involved. We want to hear from you! Let us know about great speakers you have heard or topics you want to learn about. Tell us about what is going on in your lab. Connect with your friends and colleagues on our Facebook page. Invite a friend to join the society. We are here for you.

Thanks again for your continued support. I look forward to seeing you in the fall in Chapel Hill.

John Cotton, MD, FACC
I would like to take this opportunity to thank Marta Thorup for the many years of dedicated service she has given to the society as the newsletter editor. Marta was tireless and unwavering in her commitment to provide an informative and entertaining newsletter. Thank you Marta!

As your new newsletter editor, along with Susan Fail as co-chair of the communications committee, we will strive to provide information we think you need to know and would like to read about concerning the society and the sonography profession. It’s an honor for us to serve the largest, most successful state society in the country! In this issue of the newsletter, you have already read the message from our President about the annual symposium recently held at the Grove Park Inn. In addition, a popular speaker at the symposium has graciously written an interesting article for this newsletter and be sure to read the ‘case of the day’ with the winners of the correct answer listed.

I am always amazed at the marvelous scientific exhibits entered by the NC sonography students each year! The information and creativity used in creating the exhibits are a testament to the students themselves and to the programs where they study. Watch for articles on the exhibits in future newsletters.

We are always interested in your ideas for news articles. If you have an interesting case come through your lab, submit a case study! Contact either Susan or me through the NCUS Central Office.

Have you checked out the NCUS Facebook page lately for up-to-date society information?

Have a nice Spring!
Teresa Jones
Charlotte Henningsen, MS, RT(R), RDMS, RVT, FSDMS, FAIUM
Adventist University of Health Sciences
Orlando, FL

With the miniaturization of the ultrasound machine came the concept of “point of care” imaging. It has been defined as the limited use of ultrasound to answer a specific question and has been described as an ultrasound stethoscope. With that came concern about whether or not appropriate education would occur; since, we all know that sonography is very operator dependent. The discussion has also been somewhat politically charged, especially with regards to reimbursement.

Six years ago, I was asked if I could assist with the sonography education of emergency medicine residents when Florida Hospital, in Orlando, launched a new residency program. The American College of Emergency Physicians (ACEP) has a well-defined educational process for emergency medicine residents that contains an ultrasound component. I worked with an emergency physician who had completed a fellowship in emergency medicine ultrasound, and we followed those guidelines carefully in setting up the ultrasound component.

New residents engage in what we call ED Bootcamp consisting of 5 weeks of lecture and lab, four hours per week. It includes basic physics and instrumentation, sonographic terminology, and an introduction to sonography organizations and ergonomics. Then we teach specific exams focusing on the “point” in point of care. Lectures include the FAST (trauma) exam, venous access (intravenous lines), gallbladder (rule out gallstones), renal (rule out hydronephrosis), cardiac (tamponade, pericardial fluid, standstill), female pelvis (confirm IUP), venous (rule out DVT), and aorta (rule out aneurysm/rupture).

Residents are assigned ultrasound rotations during the three-year residency, and I spend one afternoon a week instructing the residents in focused bedside ultrasound. It has been this process of working with the residents in the ED that has been the most rewarding and challenging for me. It can be very fast paced and sometimes emotionally draining.I have seen the rapid response to surgical emergencies save lives, as in a patient with a ruptured aneurysm who was rushed straight from bedside ultrasound to the operating room. And I have seen patients loose their battles with drug addiction, in motor vehicle accidents, and from violent attacks….it saddens me. I have the privilege of interacting with patients at the most vulnerable times of their lives and deaths. I have the honor of ensuring that through my actions, they are all treated with dignity and respect…..this is part of my purpose as a healthcare professional and sonographer.
PATIENT HISTORY
39 year old male presented to ultrasound department with:
  • Right sided testicular pain
  • Palpable mass in right scrotum
  • Fever
  • Chest pain
  • Dry cough
  • Raised-red rash on shins

Sarcoidosis is a benign disease in which multiple organs are affected when granulomas become inflamed. It occurs most often in lungs, but can also affect skin, eyes, lymph nodes, liver, spleen, and male and female reproductive organs.1

Sarcoidosis typically begins between the ages of 20-40 years old.

The cause of sarcoidosis is unknown, but some research suggests that it is linked to bacteria, viruses, or chemicals may trigger the disease.2

CLINICAL FINDINGS
Sarcoidosis is a multi-system disorder. Symptoms will vary depending on which organ the disease is affecting.1
  • Chest pain
  • Shortness of breath
  • Dry cough
  • Fatigue
  • Joint pain
  • Hair loss
  • Rash
  • Headache
  • Discharge from eyes
  • Burning itching eyes

LABORATORY FINDINGS
This disease may cause abnormal lab values in some or all of the following:
  • CBC
  • Calcium (serum, urine, ionized)
  • LFTs
  • Quantitative immunoglobulins
  • Serum Phosphorus 

SONOGRAPHIC FINDINGS
  • Multiple Hypoechoic nodules
  • Hyperemic
  • Possible calcifications
  • Hepatomegaly
  • Splenomegaly
  • Enlarged lymph nodes



DIAGNOSIS
Sarcoidosis can be challenging to diagnosis due to the vague symptoms that can mimic other disease. Chest x-rays are extremely helpful in identifying sarcoidosis in the lungs; however sonography, MRI, and CT are used to detect the disease in other organs. A biopsy of the affected tissue will result in definitive diagnosis.

TREATMENT
Symptoms of sarcoidosis will most often subsided without any treatment. However, patients in which the disease affects the lungs must be put on a steroid therapy that can last up to two years. Immunosuppressant medications are used in conjunction with steroids for extremely severe cases.1

PROGNOSIS It is estimated that 30-50% of patients that suffer from sarcoidosis will get better without treatment within 3 years. About 20% of patients whose lungs are affected will suffer from permanent lung damage. Death may also occur in 5% of patients with sarcoidosis due to bleeding from the lungs, heart damage, and lung scarring.1

REFERENCES 1. Dugdale, D. (2011, June 2). Sarcoidosis. Retrieved January 5, 2013, from PubMed Health: www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001140/ .
2. Foundation For Sarcoidosis. (2012). Sarcoidosis and The Body. Retrieved January 5, 2013, from Stop Sarcoidosis: www.stopsarcoidosis.org./sarcoidosis/symptoms.htm.

WINNER OF THIS CASE IS BRITNEY HICKS! WAY TO GO BRITNEY!!!


WINNERS OF CASE OF THE DAY 2 ARE:
Jenny Epperly, Brian Kilpatrick, Michelle Dail, Chasity Silver, Danielle Downs, Jeanne Gentry, Ivanna Petrovsk, Stephanie Davis, Mary Alice Bradley, Chelsea Atkinson, Taylor Holcombe, Marian Catlin, Rebecca Meert, Cecilia Wilson, Jana Pierson, Angela Sanderson, Jill Feimster

Congratulations to all of you!
Contributed by Marta Thorup Sometimes you can't help but laugh at all the funny things patients say! I love it! It definitely makes our job more interesting.

Doctor ordered a testicular ultrasound on a 85 year old man to literally find his ball. Apparently he had it and then lost it. His elderly wife came to the appointment with him and made wise cracks the whole time at his expense, but both of them were hilarious about it. She said they just came from Walmart, standing in the produce section she discovered a meatball on the floor. She said pointing, "Look Honey I found your ball!" Haha!