Knobology

1. Knobology Kevin deWeber, MD, FAAFP, FACSM Military Sports Medicine Fellowship Director Uniformed Services University, Bethesda, MD Slides from Andrews Institute Ultrasound Course 2011 With a few additions. Courtesy: Sean N. Martin, DO, CAQSM Capt, USAF Faculty, Family Medicine Residency Eglin AFB, Florida

2. What is “Knobology??” “The fabricated word that implies the study of gadgets and gizmos (i.e “knobs”) found on machinery used in musculoskeletal ultrasound.” ~SNM 2008 Wald, Matthew L., For Air Traffic Trainees, Games With a Serious Purpose, New York Times, Oct. 7, 2008 2003 December, C. A. Mobley and Michael Benson, The Complete Idiot's Guide to Aircraft Carriers, page 247, Alpha Books

3. Knobology is Serious Stuff

4. Agenda Basic Controls - Mode - Frequency Image Balance - Gain - TGCs - Depth - Focal Zones Function Miscellaneous - Panoramic View - Capturing Images - Cross Beam (GE), MultiBeam (Sonosite) Examples provided by GE Logiq E, Sonosite M Turbo, Terason T3200

5. Terason T3200 Ge LogiqE Sonosite M-Turbo

6. Basic Controls - Mode - Frequency Image Balance - Gain - TGCs - Depth - Focal Zones Function Miscellaneous - Panoramic View - Capturing Images - Cross Beam (GE), MultiBeam (Sonosite) Examples provided by GE Logiq E and Sonosite M Turbo

7. Mode Arc

8. Mode Arc

9. Mode Arc

10. Modes

11. Modes

12. Modes • QUALITATIVE • Gives You: • Presence of Vascularity • Direction of Flow • Does Not Give You: • Flow Velocity

13. B Mode, 2D Mode

14. Color Flow, Color

15. Modes • QUANTITATIVE • Gives You: • Presence of Vascularity • Velocity of Flow

16. B Mode, 2D Mode

17. Pulsed Wave, Doppler

18. Modes • SUPER SENSITIVE QUALITATIVE • Gives You: • Very Sensitive Assessment of Presence of Flow • Does Not Give You: • Direction of Flow • Velocity of Flow

19. B Mode, 2D Mode

20. B Mode, 2D Mode

21. Basic Controls - Mode - Frequency Image Balance - Gain - TGCs - Depth - Focal Zones Function Miscellaneous - Panoramic View - Capturing Images - Cross Beam (GE), MultiBeam (Sonosite) Examples provided by GE Logiq E and Sonosite M Turbo

22. Frequency Higher Frequency: - Less Penetration - More Resolution Lower Frequency: - More Penetration - Less Resolution

23. Frequency

24. Frequency

25. Frequency

26. Frequency

27. Basic Controls - Mode - Frequency Image Balance - Gain - TGCs - Depth - Focal Zones Function Miscellaneous - Panoramic View - Capturing Images - Cross Beam (GE), MultiBeam (Sonosite) Examples provided by GE Logiq E and Sonosite M Turbo

28. Gain Serves to amplify signal being reflected back to transducer Similar to a VOLUME button

29. Gain

30. Gain

31. Gain

32. Gain

33. Auto-Optimization Machine provides its own interpretation of the most optimal level of gain For use in B and Doppler Modes only

34. Auto-Optimization

35. Auto-Optimize

36. Auto-Optimization

37. Auto-Optimization

38. Feeling a tad overwhelmed yet?

39. At least you don’t have to memorize all this…..

40. Basic Controls - Mode - Frequency Image Balance - Gain - TGCs - Depth - Focal Zones Function Miscellaneous - Panoramic View - Capturing Images - Cross Beam (GE), MultiBeam (Sonosite) Examples provided by GE Logiq E and Sonosite M Turbo

41. TGCs Time Gain Compensation (TGC): Series of EQUALIZER sliders that fine tune the “volume” at various depths * Sonosite makes use of the Near and Far Gain feature for this purpose

42. TGCs

43. Far and Near Gain

44. TGCs

45. TGCs

46. Basic Controls - Mode - Frequency Image Balance - Gain - TGCs - Depth - Focal Zones Function Miscellaneous - Panoramic View - Capturing Images - Cross Beam (GE), MultiBeam (Sonosite) Examples provided by GE Logiq E and Sonosite M Turbo

47. Depth This controls the beam’s field of view Idea is to maximize size of image on the screen while also capturing all pertinent anatomy

48. Depth

49. Depth

50. Depth Centimeters