Hi Everyone from blizzardy Northwest New Jersey!
We want to know how confident (or not!) all of you are at finding adrenals, and not just a “phantom”-type image but a good diagnostic one! Can you image as pretty as the one here? What are all of your specific issues? What is your method? Sweep an area and hope or are you able to hone in?
SonoPath is getting ready to launch a new email campaign we call “No Adrenal Left Behind”, a series of gorgeous monthly educational email blasts that will cover such topics as
Hi Everyone from blizzardy Northwest New Jersey!
We want to know how confident (or not!) all of you are at finding adrenals, and not just a “phantom”-type image but a good diagnostic one! Can you image as pretty as the one here? What are all of your specific issues? What is your method? Sweep an area and hope or are you able to hone in?
SonoPath is getting ready to launch a new email campaign we call “No Adrenal Left Behind”, a series of gorgeous monthly educational email blasts that will cover such topics as
- anatomy (incredible 3D video that really fixes positioning in your mind)
- the SDEP protocol which we teach at all of our abdominal training seminars designed to get every adrenal every time
- how to get your eye to pick up on one key adrenal feature….
- tips on imaging your best adrenal!
- ascites, obese, giant, deep chested, cushings, addisonian, CVC invasion, feline, it doesn’t matter – never miss another adrenal or adrenal pathology!
Look for the first in the series coming within the next few days! And please keep this thread going and let us know if they are helpful to you – we are all in this together and the better you can image, the more accurate the assessment!
Comments
The reason behind this
The reason behind this campaign is that adrenal apathology is the most common second opinion pathology I have run into over the years because the first sonographer didnt image them adequately leading to misdx and further patient decline. Hope you enjoy this series both in the forum and on email links.
Best regards
Looking forward to this
Looking forward to this series. I can usually image the L adrenal gland. I have more trouble with the R adrenal when we have a deep chested dog and I have to try and view the image intercostal. In fact- I find it difficult to get great images intercostal from the R side. May have to attend the SDEP seminar.
Our next SDEP abdominal
Our next SDEP abdominal seminar is in Vancouver, May 12-14 2017. We are really excited to be teaching SDEP on the west coast! You can find details and a link to registration here
http://www.sonopath.com/events/2017-sonopath-sdep-ce-events/sdep-abdomen-may-12-14-2017-vancouver-canada
We would love you to join us there Dr Herman! I can show you my technique for gettting that right adrenal on a giant or deep chested dog:)
Email 1 of 7 of the SonoPath
Email 1 of 7 of the SonoPath “No Adrenal Left Behind” campaign has gone out! You should all have it in your emails, check it out AND look at the supporting materials on our website in our instructional library under RESOURCES here:
http://sonopath.com/resources/instructional-library-sonopodcasts-interventional-procedures/no-adrenal-gland-left-behind-
New emails and new material to be added to the website every week!
Any questions/problems and most importantly SUCCESSES please share on the forum – we want to see your great images!! And not-so-great images we can help you perfect:)
You can also reply directly to the email and we will answer you personally, but please ONLY technique queries, save anything interpretational for the forum or for the telemed cases you send in:)
OK- here is my biggest
OK- here is my biggest issue.
Most of the time the L adrenal is not a problem and pretty straight forward.
R adrenal is another story when you are imaging a deep chested dog intercostal. I can often get the kidney longitudinal. The technique is then to “press” gently and drop the tail. The problem is “pressing” when interocstal. Not much give there. Sometimes I can catch part of the R adrenal just caudal to the Ribs- but I usually only get the caudal pole even when I move the tail cranial. Also a problem getting the colon out of the way.
I am certain I am not alone with this issue.
When you look at the 17 point SDEP program you understand the process- but the images shown on the video look much different than what I see with my curvilinear probe.
I do intend on attending the program when I can. Scheduling has been an issue.
I agree those are the
I agree those are the toughest. Make sure the dog is elevated at least 45 degrees or in a trough. Yes you can’t really “press” when you are intercostal, but once you have the flat RK drop the tail and fan. The RADR will ineveitably be deeper than when you are not intercostal, sometimes 5-8 cm. But generally you can still see the CVC and Aorta, do a fan, look for the bright phrenic vessels. Take your video and many times I think I have not gotten it, but when I go back to review I look for the phrenics then I pick up the shape.
With giant dogs I have another technique that is more successful for me and the first time I tried it, it was out of desperation. I say “OK get the dog off the table, let him stand facing away from me”. follow these guidelines-
again, I can’t stress enough to look for those bright hyperechoic phrenics then your eye will start to recognize the adrenal.
I will try this next time
I will try this next time with a giant breed.
Thanks
Part 2 of the “No Adrenal
Part 2 of the “No Adrenal Left Behind” campaign is out today, be sure to check your emails. And we have followup on our RESOURCES page, in the instructional library. Lots of pics on phrenic vessels so you can learn to identify them – and dust off that linear probe that you may not use much and find those adrenals and watch them light up!
I challenge you to use the linear this week and post some pics of those adrenals! And if you can, put an arrow on the phrenic vessels!
Look for those phrenics!!