When you have your annual physical exam, your doctor takes your blood pressure, listens to your heart and lungs, and gently presses on your abdomen. It’s a process that has remained relatively unchanged for several hundred years, says Dr. Gian Corrado, head team physician at Northeastern.
But what if there were a better way to assess your health? Ultrasounds could allow physicians to look at what’s going on inside their patients. Corrado, whose research focuses on using ultrasounds to detect thickened or enlarged heart tissue in young athletes, is trying to enable frontline care providers—primary care physicians, physician assistants, athletic trainers, physical therapists—to incorporate ultrasounds into their regular practice.
“There are all these incredibly cool things that can be done,” says Corrado. “We want to excite providers, get their hands on an ultrasound machine, and start answering clinical questions of their own.”
Corrado, who is also the associate director of the sports medicine fellowship at Boston Children’s Hospital, will be teaching around 50 frontline care providers how to use these machines at a symposium June 1 at Northeastern. The symposium, which is co-hosted by Boston Children’s Hospital, will include a series of lectures and provide attendees with hands-on experience with pulmonary, cardiovascular, abdominal/renal, and musculoskeletal ultrasounds. Corrado hopes the machines will become a standard part of patient care, instead of a test reserved for special circumstances.
“Every frontline physician needs to be able to tell their 80-year-old patient, ‘Your kidneys look the same as they did last year. Your aorta is the same size,’” Corrado says. “That would be such value added to the physical exam.”
This is how I find myself lying on an examination table with a paper towel tucked into my sports bra, as Corrado points out my organs on a shifting black and white screen.
Ultrasound machines construct images by emitting high-frequency sound waves and listening to the noises that bounce back—the medical technology version of a bat’s echolocation. This sending and receiving is done through a hand-held wand smeared in a thick layer of gel.
I ask Corrado about the transparent goop as the wand glides across my ribs. It’s goop, he deadpans. But goop with a purpose. It helps the sound waves transmit smoothly into my body, without being disrupted by the air.
We begin the guided tour of my internal organs with the liver. Corrado has to angle the wand so that the sound waves avoid my ribs, which show up on the screen as blurry black shadows that obscure everything behind them. He is hunting for Morison’s pouch, a space between the liver and kidney that is supposed to be empty. If it were instead full of fluid, that would show up on the ultrasound.
Corrado didn’t learn to use an ultrasound in medical school–most physicians don’t. But there was one in the emergency room where he completed his residency, on the South Side of Chicago, and emergency care providers were starting to use it.
“You started to see incredibly important questions being answered,” Corrado says. “Here’s a trauma patient, is there blood in their belly? That can be answered in 30 seconds with one of these machines. It saved so many lives.”
Ultrasounds can also be used to quickly check for a collapsed lung, fluid around the heart, cysts in the liver, and viable pregnancy, among other things. They have been invaluable for emergency medicine.
“Every single ER has multiple ultrasound machines, and multiple trained emergency physicians who know how to use them,” Corrado says. “That exact same thing needs to happen in clinical offices.”
Physicians conducting annual physical exams are still using stethoscopes to listen to your heart and lungs, Corrado says. With an ultrasound, physicians could quickly and thoroughly examine a patient, catch potential health issues early, and track changes from year to year.
“Wouldn’t you like to go to your doctor and, instead of telling you that your heart sounded okay, they told you that it looked okay,?” Corrado asks.
He shifts the wand to point out my inferior vena cava and my aorta—the major vein and artery coming to and from my heart. At this angle, the two black circles look like a pair of eyes staring out of the ultrasound screen. But they’re easy to tell apart when Corrado pushes down lightly on my stomach. The inferior vena cava winks.
Corrado assures me that it’s supposed to do that. My inferior vena cava, like the rest of me, seems to be in fine shape.
“The ultrasound is going to replace the stethoscope,” he says. “The question is, can we make it happen in five years or is going to take another 20.”