What Are the Different Types of Sonographers?

Sonography is a type of diagnostic imaging that helps doctors see various parts of the body to help them evaluate and monitor various health conditions in men, women, and children. Often called ultrasound, sonography sends sound waves into the part of the body the doctor wishes to examine. The role of the sonographer is to take the images and present them to the doctor or physician, to talk with the patient during the imaging session, and to help identify abnormalities.

Being a sonographer, sometimes called an ultrasound technician, and professionally called a Diagnostic Medical Sonographer, is an exciting and fulfilling career. Students can focus on general sonography or specialized sonography. Once the student obtains their certification as a diagnostic medical sonographer, they can then further their education to specialize in a variety of sonography concentrations.

What Is Sonography?

Sonography uses tools to diagnose the inside of the human body using ultrasound. Sonography is a diagnostic imaging technique using pulses of high-frequency sound waves to probe tissues, organs, blood vessels, or a fetus. The sonographer moves a hand-held non-invasive probe along the surface of the skin to obtain different views of the object being imaged. The echoes that bounce off of the tissue create dynamic and clear visual images that help the physician to see inside the body.

Ultrasound or sonography provides images in real-time. Ultrasound machines also give the sonographer the ability to wheel the machine to immobile or very sick patients without risking further harm to the patient. Sonography technology doesn't use the harmful ionizing radiation that X-ray machines use, making sonography a safer form of medical imaging.

Ultrasound was originally used as a navigational tool in the 1940s when ships navigating the ocean would bounce sound waves off of the ocean floor and read the echoes that returned. This technology, called SONAR, is still used to this day for scientific exploration of the oceans. In the 1950s and 1960s, doctors began to use sound waves for heart patients.

Today, ultrasound and sonography use advanced technology integrated with sophisticated computers to create dynamic pictures that help doctors view various parts of the human body to help with their medical diagnoses.

What Is a Sonographer?

A sonographer, also referred to as a diagnostic medical sonographer (DMS), works with doctors and medical practitioners to provide images from the ultrasound machine. Sonographers make sure the equipment is in proper running condition. The sonographer reviews the doctor's orders, looks at the patients' medical history, and explains to the patient what to expect during the imaging process.

It's important for a sonographer to develop a rapport with patients while displaying confidence and professionalism at all times. After preparing the patient for their procedure, the technician explains each step of the process.

Once the patient is ready for their ultrasound, the technician then applies a conductive gel to the skin where the image is being taken. The technician then moves the probe which sends the sound waves through the body. The ultrasound machine then sends the sound waves back to the visual display so the technician can see the image. The sonographer records the findings in the patients' file and submits the images and analysis to the patients' physician. Of course, the exact processes might differ depending on the site, doctor, or method taught.

One of the requirements to become a Diagnostic Medical Sonographer is to have, at a minimum, an Associate degree in applied science. This is applicable whether the student is planning on being a general ultrasound technician or becoming a specialized sonographer. Because the human body is so complex, specializing in imaging for each unique system and body part is necessary for proper diagnosis.

Let's take a look at several concentrations and fields that a sonographer can specialize in. Please note that only the Diagnostic Medical Sonography and Diagnostic Cardiovascular Sonographer programs are offered at Concorde.

Diagnostic Medical Sonography

A diagnostic medical sonographer, sometimes known as an ultrasound technician, utilizes the education they have received to work with the doctors for medical diagnostics. With licensing, certifications, and higher education, an ultrasound technician can specialize in a certain field. A generalized sonographer understands basic human anatomy, medical language, how to use the equipment, how to write reports, and how to present the images to the doctor or physician. Skills for any sonographer or ultrasound technician include:

• Active listening. Patients will have questions about the procedure and process of medical imaging. It's essential that ultrasound technicians fully understand what they are doing and be able to respond to the questions the patient is asking.
• High-quality communication skills. Undergoing ultrasound can be confusing and frightening to the patient. Carefully explaining each step of the process will help to calm them and give them the confidence that the technician is competent in their field. Communication is an essential skill in sharing reports with the doctor and other practitioners involved in the ultrasound procedure.
• Having a good bedside manner. While the technician's job is to take clear images with the ultrasound machine, it's important to develop skills that help to empathize with the patient. Talking with the patient throughout the procedure and staying calm and professional will help ease the patients' concerns.
• Understand the doctors' orders. It's important that the sonographer comprehend the medical terminology in the doctor's written report, and to have the ability to write detailed reports specific to the patient and the diagnoses.
• The ability to see abnormalities. With training and experience, the diagnostic medical sonographer will learn to spot abnormalities, whether it's a torn tendon or a blocked artery.

Diagnostic Cardiovascular (Cardio) Sonographer

Also called an echocardiographer, a cardio or cardiac sonographer works with cardiac doctors to help physicians diagnose heart problems. The equipment uses 2D and 3D images of the heart and its chambers. Physicians are looking at the structure of the heart and the blood flow to see if there are blockages or deterioration of the heart muscle. Images received help doctors prescribe treatment, surgery, or lifestyle changes to help prevent further damage to the heart.

Upon receiving the diagnostic cardiovascular sonographer certification, the student can then register to pass the credentialing examination administered by either Cardiovascular Credentialing International (CCI) or the American Registry of Diagnostic Medical Sonographers (ARDMS).

Neurosonology Sonographer

Neurosonology Sonographer is a very specialized type of sonography that uses a different type of machine than a normal ultrasound or sonogram. Also called neuroimaging, neurosonography utilizes specialized beam shapes and frequencies from a Transcranial Doppler (TCD) that is unlike traditional obstetric and abdominal sonography machines. The TCD machine monitors and measures blood flow within vessels found in the brain.

Some neurosonographers specialize in neonatal brain imaging and help when the physician is looking for neurological disorders in infants. Generally, neonatal imaging gets used on premature babies, those with a low birth rate, and babies whose mothers didn't take care of themselves during pregnancy. Images may reveal:

• Cerebral palsy
• Spina bifida
• Down syndrome
• Encephalitis

Not only are Neurosonographers imaging the brain, but they also image the spinal column and nervous system. Disorders they may find include:

• Stroke
• Aneurysm
• Alzheimer's disease
• Brain tumors
• Epilepsy
• Parkinson's disease
• Spinal stenosis
• Multiple sclerosis
• Paralysis
• Myelitis

To obtain a certification as a Neurosonology Sonographer, register with the American Registry for Diagnostic Medical Sonography (1) to receive credentials in Neurosonology. Neurosonology sonography is an emerging field in advanced ultrasound, and technicians need a solid grasp of the nervous system, spinal column, the brain, and specific medical terminology for the entire nervous system. While this specific sonography concentration isn't offered at Concorde, we offer Neurodiagnostic Technology programs which uses specialized equipment to look at a patient's nervous system.

Abdominal Sonographer

A specialized abdominal sonographer works with doctors to image organs within the abdomen. It's important for the sonographer to have a solid grasp of the abdominal area and the systems within it. The sonographer is looking for abnormalities, tumors, stones, and tissue damage in the following organs:

• Gallbladder. Ultrasound images can show gallbladder stones, which are a build-up of crystallized bile resulting in pain and inflammation.
• Kidneys. Imaging can reveal the presence of kidney stones, which are a build-up of minerals and protein in the urine and are often quite painful.
• Liver. Imaging can show tissue damage within the liver and other liver diseases.
• Spleen. Ultrasound shows abnormalities, enlargement, or damage to the spleen.
• Pancreas. Imaging can show if there is a tumor or damage to the pancreas.
• Abdominal aorta. This is one of the major blood vessels that supply blood to the body. From an ultrasound, the doctor can spot any bulging or weak spots within the aorta which may result in complications for the patient.

The doctor looks at the ultrasound images and, based on the findings, prescribes treatment as needed.

Breast Sonographer

A breast sonographer specializes in imaging the breast. The breast imaging procedure is usually performed as a follow-up to an abnormal mammogram or clinical exam. Cancer isn't detected from an ultrasound, but the technician and doctor can see dark spots that are abnormal in a healthy breast. Some of the things the physician looks for are:

• Lumps
• Cysts
• Tumors

The breast sonographer looks at nearby lymph nodes for anything unusual. In addition, the technician can use the ultrasound equipment to help guide a needle during a biopsy or to remove fluid from a cyst. Ultrasound imaging for breasts is important for performing a mammogram without radiation, if the breasts are particularly dense, or if the woman is under the age of 25.

Sonographers who wish to specialize in this field need specialized training and education.

Obstetric Sonographer 

An obstetric sonographer specializes in imaging the fetus while in the womb. They look for normal growth and development as well as any abnormalities or pregnancy complications. The role of the sonographer is to help ensure the fetus and mother are healthy. The technician verifies the woman is pregnant, checks for the position of the growing fetus, and can help to determine the due date.

Because obstetric sonography is one of the most common types of ultrasound a technician will perform, they'll receive education in this specialized field in their diagnostic medical sonography education.

Musculoskeletal Sonographer 

The sonographer takes images of muscles, tendons, ligaments, nerves, and joints throughout the body. The images are useful when looking for joint issues as well as for soft-tissue damage. The physician uses the images to look for damage such as:

• Sprains
• Strains
• Tears
• Trapped nerves (for carpal tunnel syndrome and neuromas)
• Arthritis
• Hernias
• Trapped objects (glass or splinters)
• Cysts
• Inflammation of fluid
• Other musculoskeletal conditions

By earning the Registered in Musculoskeletal (RMSK) sonography certification, ultrasound technicians become more valuable to the organization, hospital, or private physician they work with. Register for the certification with the Alliance for Physician Certification and Advancement.

What Kind of Education Do I Need to Become a Sonographer?

• Associate Degree in an applied Science (two-year degree) with a specialization in diagnostic medical sonography.
• Bachelor's Degree (four-year degree) for more advanced and specialty niches or for management positions.
• One-year certifications for individuals working in the field that already hold an Associate or Bachelor's degree.

While not all states require mandatory certifications, most employers prefer the technician to have a certification. Acquiring one gives the technician a competitive advantage.

Concorde provides students the opportunity to achieve their associate degree in Diagnostic Medical Sonography in as little as 19 to 20 months. Students learn technical skills, human anatomy and physiology, medical terminology, as well as the specifics for the specialized sonography niche the student plans to pursue. Students looking to get their sonography education at Concorde can put their focus on obtaining their certification as a diagnostic medical sonographer or a diagnostic cardiac sonographer.

The Bureau of Labor Statistics (2) states that jobs for sonographers will continue to increase. With new imaging technology emerging, invasive and dangerous imaging procedures are being replaced with safer ultrasound. Being a sonographer is a rewarding and lucrative career. Contact Concorde for more information about training for this exciting career.

Footnotes
1. American Registry for Diagnostic Medical Sonography, https://www.ardms.org/
2. Diagnostic Medical Sonographers and Cardiovascular Technologists and Technicians, Including Vascular Technologists, U.S. Bureau of Labor Statistice, https://www.bls.gov/ooh/healthcare/diagnostic-medical-sonographers.htm