The Newborn Hip: What We Can’t Feel, We Can See on Ultrasound

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At first glance, a newborn appears perfectly healthy. There is no pain, no deformity, nothing to raise concern. Yet beneath that calm exterior, the hip joint may be quietly unstable, a subtle condition with lifelong consequences if not detected early.

Developmental dysplasia of the hip (DDH) is one of the most important conditions we need to detect early in pediatric imaging. It represents a spectrum, from mild acetabular shallowness to complete dislocation of the femoral head. While many cases resolve spontaneously, others silently progress, leading to gait abnormalities, chronic pain, and early osteoarthritis if missed.

This is where ultrasound changes the story.

Unlike radiography, ultrasound allows us to see the neonatal hip before ossification begins. It provides a dynamic, real-time assessment, not just of the hip anatomy, but also of stability. In fact, it can mimic clinical maneuvers such as the Barlow test by applying gentle stress during examination, to assess whether the femoral head remains seated or slips out of the acetabulum.

Timing matters. Ultrasound is the modality of choice before 4–6 months of age, when the femoral head is still largely cartilaginous. But performing it too early—before 6 weeks—can lead to overdiagnosis due to physiological laxity caused by maternal hormones. Knowing when to scan is therefore just as important as knowing how.

A standard ultrasound examination relies on two key views:

  • Coronal view at rest: evaluates acetabular morphology
  • Transverse flexion view (with or without stress): assesses joint stability
Ultrasound image of the hip joint anatomy, showing structures such as the gluteus medius, gluteus minimus, iliac bone, femoral head, and surrounding cartilage.
Source: Robben S, Smithuis R. Radiology Assistant (https://radiologyassistant.nl/pediatrics/hip/developmental-dysplasia-of-the-hip-ultrasound)

To bring objectivity into assessment, the Graf method is the widely used technique. By identifying key anatomical landmarks (the iliac line, triradiate cartilage, and labrum), we measure two angles:

  • Alpha (α) angle: reflects the bony roof of the acetabulum
  • Beta (β) angle: reflects the cartilaginous roof

A normal hip typically shows an α angle ≥60° and β angle <55°. Deviations from these values help classify hips into types ranging from normal (Type I) to dislocated (Type IV). But beyond the numbers, what matters most is understanding what they represent: how well the femoral head is supported and how stable the joint truly is.

Screening strategies vary worldwide. Some healthcare systems advocate universal ultrasound screening, while others rely on selective screening based on risk factors such as breech presentation, family history, or associated musculoskeletal deformities. Interestingly, ultrasound can detect significantly more abnormalities than clinical examination alone.

But beyond protocols and measurements lies a bigger question:

How many cases are we missing simply because they look “normal” at birth?

Ultrasound gives us a unique opportunity, not just to diagnose, but to prevent. Early detection allows for simple, non-invasive treatments like harnessing, often avoiding surgery altogether.

As clinicians and sonographers, we are not just capturing images, we are shaping outcomes.

So the next time you scan a newborn hip, ask yourself:

Are you just measuring angles, or are you changing a life?

Dr. Dina Elraggal is a Radiology resident at the Medical Research Institute at Alexandria University in Egypt.

This posting has been edited for length and clarity. The opinions expressed in this posting are the author’s own and do not necessarily reflect the view of their employer or the American Institute of Ultrasound in Medicine.

A New Way Ultrasound May Help Protect High-Risk Pregnancies

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Pregnancy is a time of careful monitoring, especially when there are concerns about a baby’s growth. One condition doctors watch closely is fetal growth restriction (FGR). This happens when a baby is not growing as expected in the womb, which can increase the risk of complications before and after birth. 

To keep both mother and baby safe, healthcare providers rely on different tools to track what’s happening during pregnancy. Ultrasound is one of the most important of these tools. It allows doctors to see inside the body in real time and monitor how both the baby and the mother are doing. Now, newer approaches to ultrasound are offering even more insight, especially in pregnancies affected by FGR. 

Looking Beyond the Baby 

Traditionally, ultrasound exams in cases of FGR focus mainly on the baby, measuring growth, checking movement, and evaluating blood flow through the placenta and umbilical cord. While these are still essential, researchers are beginning to look more closely at changes in the mother’s body as well. 

One area of interest is the blood flow near the eye, specifically in a vessel called the ophthalmic artery. This artery supplies blood to the eye and surrounding structures, but it can also reflect what’s happening more broadly in the body’s circulation. 

Using Doppler ultrasound, which shows how blood is moving through vessels, doctors can observe patterns in this artery. Changes in blood flow here may signal that the body is under stress or adjusting in response to pregnancy complications like FGR. 

What the Eye Can Reveal 

So why focus on the eye? It turns out that the blood vessels around the eye can provide clues about overall blood flow and pressure changes in the body. In pregnancies affected by FGR, the body may adapt in ways that alter how blood is distributed. 

By studying these patterns, clinicians may gain a better understanding of how severe the condition is and how it might progress. This could be especially helpful in identifying pregnancies that need closer monitoring or earlier intervention. 

Another Clue: The Optic Nerve Sheath 

In addition to blood flow, ultrasound can also be used to look at a structure called the optic nerve sheath. This is a protective covering around the nerve that connects the eye to the brain. 

Why does this matter? Because changes in this area can sometimes reflect shifts in pressure within the body, including the head. While this might sound unrelated to pregnancy, these pressure changes can be part of how the body responds to complications. 

By measuring the optic nerve sheath, doctors may be able to gather additional information about a patient’s condition, adding another layer to their overall assessment. 

What This Means for Patient Care 

The most important takeaway is that ultrasound is becoming an even more powerful tool in managing high-risk pregnancies. By looking at both blood flow patterns and subtle physical changes, clinicians may be able to: 

  • Better identify which pregnancies are at higher risk 
  • Monitor how conditions like FGR are evolving 
  • Make more informed decisions about timing of delivery 
  • Potentially improve outcomes for both mother and baby

This approach doesn’t replace traditional ultrasound exams—it builds on them. By combining multiple sources of information, healthcare providers can get a more complete picture of what’s happening. 

A Step Toward Earlier Detection 

One of the biggest challenges with FGR is knowing when to act. Deliver too early, and the baby may face complications related to prematurity. Wait too long, and the risks from poor growth may increase. 

New ultrasound techniques like these may help doctors find that balance more effectively. Even small improvements in early detection and monitoring can make a meaningful difference in outcomes. 

Moving Forward 

While more research is still needed, this work highlights an important shift in how ultrasound is used in pregnancy care. Instead of focusing only on the baby, clinicians are increasingly looking at the bigger picture, including how the mother’s body is responding. 

This broader perspective may lead to earlier warnings, better decision-making, and ultimately safer pregnancies. 

For more detailed information, see the original article in the Journal of Ultrasound in Medicine (JUM): https://onlinelibrary.wiley.com/doi/10.1002/jum.16660 

Seeing the Unseen: What Early-Career Ultrasound Users Should Know in Obstetrics and Gynecology

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As a maternal-fetal medicine specialist, I still remember the first time an ultrasound image “clicked.” What initially felt like abstract shades of gray suddenly became a living story of anatomy, physiology, and possibility. I remember thinking that, finally, I was able to see what my mentors already knew and understood. For early-career ultrasound users in obstetrics and gynecology, that moment will come. And when it does, it transforms not just how you practice, but how you connect with patients. 

Ultrasound is more than a diagnostic tool in our field; it is an extension of the clinical exam, a real-time window into pregnancy, and often the first introduction a patient has to their baby. Few modalities in medicine combine technical precision with such profound emotional impact. 

Early on, ultrasound can feel humbling. Images may seem ambiguous, probe movements counterintuitive, and workflows complex. That’s normal. Ultrasound is an acquired skill that is both cognitive and tactile. It requires learning how to see, but also how to look. 

Start with fundamentals: 

  • Understand probe orientation and spatial relationships. 
  • Learn systematic approaches to scanning (e.g., standard planes in first-trimester and anatomic surveys). 
  • Correlate what you see with embryology and anatomy. 

This is critical. Repetition is key. The more scans you perform, the more pattern recognition develops. Also, it’s absolutely essential not to just “read” images but to perform the scans yourselves. When you have done enough scans that are normal, you begin to recognize what is not normal. What once required intense concentration becomes intuitive. Importantly, seek feedback, review images with experienced sonographers and faculty, and don’t hesitate to ask questions. Ultrasound is a team sport. 

For early-career clinicians, three areas deserve focused attention: 

1. Image Acquisition Before Interpretation 
A common pitfall is rushing to interpret before mastering image quality. A poorly obtained image can lead to misdiagnosis. Learn how to optimize depth, gain, and probe position. A clean, well-oriented image is the foundation of everything that follows. 

2. Standardization and Discipline 
Follow established protocols. Whether performing a dating scan, nuchal translucency, or detailed anatomic survey, consistency ensures completeness and safety. Checklists are not a crutch, they are a safeguard. 

3. Clinical Integration 
Ultrasound findings should never exist in isolation. Integrate them with patient history, lab results, and clinical context. For example, a borderline fetal growth parameter means something very different in a low-risk patient versus one with hypertension or prior fetal growth restriction. 

Ultrasound in obstetrics is uniquely powerful because it often informs immediate and consequential decisions. From confirming viability to diagnosing fetal anomalies, placental disorders, or multiple gestations, your scan can change the trajectory of care in real time. 

With that power comes responsibility: 

  • Recognize your limits and escalate when needed. 
  • Document thoroughly and accurately. 
  • Communicate clearly with both patients and colleagues.

Equally important is how we convey findings. Ultrasound is often performed in the presence of the patient, creating moments of vulnerability and anticipation. Early-career users should develop not only technical skills, but also communication skills, such as how to balance transparency with sensitivity, and how to navigate uncertainty with professionalism. 

Few areas of medicine demonstrate the impact of imaging as vividly as obstetrics and gynecology. Ultrasound allows us to: 

  • Diagnose ectopic pregnancies and prevent life-threatening complications. 
  • Establish accurate gestational dating, which underpins nearly every obstetric decision. 
  • Detect fetal anomalies early, enabling counseling, intervention, and informed planning. 
  • Monitor fetal growth and well-being, guiding timing of delivery. 
  • Evaluate placental location and pathology, critical for preventing hemorrhage and optimizing outcomes. 

But beyond clinical metrics, ultrasound builds connection. It is often the first time a patient sees their pregnancy visualized—a moment that can anchor trust and engagement in care. 

If you are early on your ultrasound journey, be patient with yourself. Mastery does not happen overnight. But know that every scan you perform is building a skill set that is both highly technical and deeply human. 

Ultrasound teaches us to slow down, to observe carefully, and to respect the complexity of what we cannot see with the naked eye. In obstetrics and gynecology, it also reminds us that we chose this field to care for patients at some of the most meaningful moments of their lives. 

Joanne Stone, MD, is Professor and System Chair, and Ellen and Howard C. Katz Chair in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai. 

A woman with long red hair wearing a beige suit and a sequined top stands confidently in front of a colorful abstract ocean landscape.

This posting has been edited for length and clarity. The opinions expressed in this posting are the author’s own and do not necessarily reflect the view of their employer or the American Institute of Ultrasound in Medicine.

Focused Ultrasound and Parkinson’s Disease: New Noninvasive Treatment Options

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Parkinson’s disease (PD) is a progressive neurological disorder that affects movement and can dramatically impact quality of life. While medication remains the first-line therapy for most patients, many people eventually experience symptoms that are no longer well controlled with medication, such as tremor, rigidity, slowness of movement, and medication-related dyskinesia.

Focused ultrasound as a treatment for Parkinson’s disease recently received new attention when Rebecca King-Crews, wife of actor Terry Crews, detailed her focused ultrasound treatment for Parkinson’s-related tremor on TODAY, People.com, and other outlets, helping raise awareness of this emerging option.

Background

In the U.S., focused ultrasound has been helping to address a critical treatment need for years. This therapy was approved by the U.S. Food and Drug Administration (FDA) for tremor-dominant PD in 2018. Three years later, the FDA expanded its 2018 approval to include the treatment of mobility, rigidity, and dyskinesia symptoms.  

New Advances: Bilateral Treatment and New Target

In 2025, patients with PD benefitted from another significant step forward when the FDA approved bilateral focused ultrasound treatment. This approval meant that patients with certain expressions of PD now had the option to receive treatment on both sides of their brain in two sessions at least six months apart. This staged approach is designed to improve symptom control on both sides of the body while maintaining patient safety. The expansion is important because PD commonly affects both sides of the body, particularly as symptoms progress.

The latest approval is also different in that it specifically applies to targeting the brain’s pallidothalamic tract (PTT). Treating this target allows physicians to address a broader range of advanced motor symptoms, including rigidity and dyskinesia, in addition to tremor. This represents an important evolution in focused ultrasound therapy, expanding its potential benefit for patients with more complex or progressed Parkinson’s disease.

Additional Information for Patients

It is important to note that these current approved uses of focused ultrasound only address the symptoms of PD; they are not a cure for the primary disease. But for certain patients who need to address difficult symptoms, focused ultrasound offers a noninvasive alternative to surgery with a lower risk of complications and lower cost.

Patients who are interested in focused ultrasound for PD should talk to their neurologist about whether they may be a candidate for focused ultrasound. As of April 2026, staged bilateral treatment targeting the PTT is not covered by Medicare, although various parties are working toward reimbursement.

Treatment primarily targeting the ventral intermediate nucleus for Parkinsonian tremor is currently covered by Medicare in Alabama, Alaska, Arizona, California, Connecticut, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, Nevada, New York, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia, Wyoming.

Treatment targeting the globus pallidus for Parkinsonian dyskinesia is covered by Medicare in Connecticut, Illinois, Massachusetts, Maine, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin.  

Patients with medication-resistant movement disorders can take a short quiz on the Insightec website to see if they may be candidates. They can also speak with a program engagement team member at Insightec to learn more by calling 1-800-704-6797.

Tim Meakam, MD, is Co-Director of the Research and Education Team at the Focused Ultrasound Foundation.

How Doctors Use Ultrasound to Spot Dangerous Fluid After a Child Is Hurt

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When children are seriously hurt in accidents, doctors need to act fast. One of the biggest worries after a child is hurt in the belly area is internal bleeding (blood that collects deep inside where you can’t see it). This type of bleeding can be life-threatening but hard to detect just by looking at the child or doing a physical exam.

That’s where a tool called FAST, short for Focused Assessment with Sonography for Trauma, comes in. FAST is a type of ultrasound test used in emergency care to quickly look for problem areas inside the body. It’s safe, it doesn’t use radiation like X-rays or CT scans, and it gives doctors real-time pictures of what’s happening inside.

One important part of FAST is checking the pelvis, the lower part of the belly area, for what doctors call “free fluid.” In trauma patients, free fluid almost always means blood from an injury. The more fluid that’s there, the more likely that serious internal bleeding is happening. But not all fluid is easy to see or measure, especially when the amount is small. So how well can doctors actually estimate the amount of fluid when they look at the ultrasound screen?

How reliable are doctors when they make a quick judgment by eye, or gestalt, about fluid volume on a pelvic FAST exam in children? Can doctors consistently recognize when there’s enough fluid to be concerning versus when the fluid is minor and probably not dangerous.

  • Doctors who are trained in ultrasound do a good job of distinguishing between larger amounts of fluid and smaller amounts. In other words, experienced clinicians can reliably tell when the fluid is significant enough to warrant concern versus when there is just a little bit.
  • The challenge is with very small amounts of fluid. When the fluid is minimal, doctors are less consistent in their estimates. Small amounts of fluid can be subtle on ultrasound, and even experienced eyes may disagree about what they see.

Why This Matters for Children Hurt in Accidents

When a child arrives at the emergency department after an accident, time is of the essence. FAST exams are often done right at the bedside so that decisions about further care, like whether to get a CT scan or go straight to surgery, can be made quickly.

The fact that doctors trained in point-of-care ultrasound can reliably spot significant fluid means that FAST remains a valuable tool in pediatric trauma care. It helps teams identify children who may need urgent intervention without waiting for longer, more complicated tests.

At the same time, small volumes of fluid are harder to judge, which highlights the limits of quick visual estimation. In cases where only a little fluid shows up, doctors may need to be cautious and consider other clinical signs, or use additional imaging tools when possible.

Improving Ultrasound Use in Emergencies

Understanding the strengths and limits of physician judgment can help hospitals train their teams better and make more informed decisions about when to rely on FAST and when to follow up with more detailed imaging.

In a field where every second counts and where radiation exposure is a real concern, especially in children, having reliable, fast, bedside tools like FAST is a big advantage. Knowing how well those tools work in the hands of real doctors helps make pediatric trauma care safer and more effective.

Cynthia Owens, BA, is the Publications Coordinator for the American Institute of Ultrasound in Medicine (AIUM).

To read more about the FAST exam in pediatric patients, check out this article from the Journal of Ultrasound in Medicine (JUM):

A Potential Pitfall of Using Focused Assessment With Sonography for Trauma in Pediatric Trauma – Baer Ellington – 2019 – Journal of Ultrasound in Medicine – Wiley Online Library

Advancing Ultrasound Through Innovation: AIUM’s Voice on Capitol Hill

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As the AIUM continues our commitment to advancing the safe and effective use of ultrasound, we are taking important, new steps into the world of advocacy. While this work is still relatively new for our organization, our approach is clear: remain firmly nonpartisan, stay aligned with our mission, and engage thoughtfully in conversations that shape the future of imaging and patient care. Our recent efforts demonstrate our growing readiness to be an active, informed voice on behalf of you, our members, the ultrasound community at large, and the patients and individuals we serve directly and indirectly. 

As we complete our current stretch of advocacy in Washington, D.C., I want to share how the AIUM’s recent efforts positioned us for meaningful and influential conversations with policymakers recently. 

In Summer 2025, the AIUM Board of Governors approved a structured, objective process for evaluating when and how we engage in advocacy. This framework has guided our actions, ensuring that every step we take aligns with our mission and strategic priorities. 

Using this tool, in the face of suggested cuts of 40% and more to imaging research and development in the United States, the AIUM joined more than 400 organizations in November 2025 to request a full restoration of NIH funding for FY26 in the federal appropriations process. That collective effort had a measurable impact: when the FY26 appropriations minibus was signed in February 2026, Congress not only rejected proposed NIH cuts but increased funding to $47.22B, a $216M increase over FY25. 

Our momentum continued when we were invited to support the Association of American Medical Colleges’ Ad Hoc Group’s FY27 NIH funding recommendation of $51.3B—an 8.7% increase over FY26. Just last month, I approved our participation and the AIUM signed that letter of support. At the time, 257 organizations had already publicly supported the request, and we continue to monitor developments as the FY27 process moves forward. 

Now, we turn toward our recent advocacy moment. 

The AIUM’s Recent Hill Days: March 24–25 in Washington, D.C. 

This year’s activities, organized by the Academy for Radiology & Biomedical Imaging Research, provided the AIUM with a significantly expanded platform to highlight the value of ultrasound, the importance of imaging research, and the need for strong, sustained NIH FY27 funding. The AIUM joined with 14 other imaging and radiology-focused organizations to advocate for uninterrupted funding, national investment in ultrasound and imaging advances, and highlight the benefits that ultrasound provides as a safe, effective, and portable diagnostic and therapeutic modality.  

A group of eight professionals posing together on a city street with the U.S. Capitol in the background, surrounded by trees.
Various members from our Hill Day coalition.

Kevin Haworth, PhD, FAIUM, FASA, who is an AIUM Fellow and Board Member, and I were joined by 50+ other individuals from across the organizations participating, representing a broad range of imaging expertise, modalities of interest, and from academic, non-profit, medical, and commercial sectors. 

Here is an outline of our time on Capitol Hill: 

March 24 – Full Day of Congressional Meetings  

Hill Day itself included a full schedule of congressional discussions, including targeted outreach to legislative offices from Vermont and Ohio, which are Kevin and my home states, respectively. The organizers also paired my group with visits to the offices of Wisconsin lawmakers. 

My group was able to speak to the offices of both Vermont and both Wisconsin senators, and the Vermont At-Large representatives, as well as the Representative from Wisconsin OH-05. Kevin was able to meet directly with Senator Jon Husted of Ohio, as well as the office of Senator Bernie Moreno. Kevin also held conversations with Representative Shontel Brown of OH-11, and briefly visited the offices of Representatives Greg Landsman (OH-01) and Warren Davidson (OH-08).

These conversations allowed us to share firsthand how ultrasound improves patient outcomes, strengthens access to care, and supports high-value clinical practice across diverse medical settings. This was also our moment to voice clear support for robust NIH FY27 investment.

Three men in business attire posing for a photo in an indoor setting with a blue backdrop.
Kevin Haworth (a current AIUM Board member), Jonathan Dillman (a former Board member), and Senator Jon Husted of Ohio.

March 24 – Evening: Medical Imaging Technology Showcase 

A man in a suit uses a handheld ultrasound device while examining an image on a tablet in a conference setting.
Kevin Haworth demonstrating tablet-based ultrasound imaging.

That evening, we shifted further from policy to demonstration. At the Medical Imaging Technology Showcase, Kevin educated attendees about ultrasound and attendees were able to explore ultrasound imaging innovations firsthand. And thanks to the kind support of EchoNous of a portable, tablet-based ultrasound machine, we even had the opportunity to conduct live educational demonstrations for at least two of the Congressional staffers during the visits. This hands-on engagement helps ground our policy priorities in real-world applications, offering a powerful complement to the day’s meetings.

March 25 – Academy Research Roundtable: AI-Driven Advances in Imaging 

Our Hill activities concluded with the Academy’s Research Roundtable, with the morning session this year focusing on AI-driven advances in imaging. This discussion explored how emerging technologies are reshaping diagnostics, improving efficiency, and expanding clinical capability, further underscoring the importance of sustained federal investment in imaging research and innovation. The afternoon sessions explored strategies to strengthen the talent pipeline, supporting researchers across their career stages while fostering interdisciplinary collaboration. 

Two men standing outside the American Association for the Advancement of Science building, with a stone wall featuring the organization's name.
Kevin Haworth and David Jones at the American Association for the Advancement of Science.

My Reflection on Our Time on Capitol Hill 

Together, these three days reflect the full spectrum of what advocacy can be: preparation, conversation, demonstration, and collaboration. The AIUM’s presence in Washington underscores our commitment to advancing ultrasound, supporting research, and ensuring that policymakers understand the essential role imaging plays in modern healthcare.  

If you have any feedback on this topic specifically, or on whether the AIUM should do more or less nonpartisan advocacy in the future, please reach out to me at president@aium.org.  

I am proud to represent our organization and to continue our work to elevate the impact of ultrasound nationwide. 

 
David C. Jones, MD, FAIUM  
President, American Institute of Ultrasound in Medicine 
AIUM Member since 1993  
Director, University of Vermont Medical Center Fetal Diagnostic Center  
Professor of Obstetrics, Midwifery, Gynecology and Reproductive Science 
Division of Maternal-Fetal Medicine 
Larner College of Medicine 
University of Vermont, Burlington  

An Open Invitation to Attend the AIUM’s 2026 Convention

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As a perinatologist, long-time AIUM member since 1993, and President of the organization, I want to invite you to join us at the upcoming 2026 AIUM Annual Convention: The Ultrasound Event—a gathering that continues to remind me why I first fell in love with ultrasound and with this organization. Every year, I leave the convention inspired by the innovation, collaboration, and passion that define the AIUM community.

This year, we are honored to welcome our keynote speaker, Professor Alison Noble CBE FRS FREng. A global leader in biomedical engineering and the Technikos Professor at the University of Oxford, Professor Noble has pioneered interdisciplinary advances at the intersection of artificial intelligence and medical imaging. Her group’s influential work in ultrasound AI—now used in clinics around the world—embodies the forward‑thinking innovation that defines our field. Her leadership across major scientific organizations further underscores the vision she brings to this year’s program.

This Convention is more than an opportunity to earn CME credits or hear world-class presentations. It is a chance to come together as physicians, sonographers, scientists, and students dedicated to advancing the field of medical ultrasound. In these unpredictable times, our ability to learn from one another, share discoveries, and strengthen our community has never been more important.

To all of our members of any professional title, background, or area of focus, I want to share what makes this meeting truly special to me. One of the things that makes the AIUM Annual Convention different to me is how well-rounded and interdisciplinary it is. Whether you’re a radiologist refining your diagnostic precision, a sonographer looking to expand into musculoskeletal ultrasound, a scientist presenting new research in therapeutic ultrasound, or someone just beginning to explore the fundamentals, this is the place to learn from each other. That cross-functionality is our greatest strength; it is where innovation happens. At last year’s convention, I listened as an obstetrician colleague compared notes with a dentist on imaging techniques, each walking away with new ideas they could apply in their own practice. It’s that spirit of curiosity, openness, and collaboration that makes the AIUM Convention unlike any other in the medical field.

A special note that I want to highlight: Please bring your students and trainees to Philadelphia. I am proud to have championed a special “In-Training” registration rate this year, and we want to those in training to become more involved. Help us mentor the next generation of ultrasound professionals, and let’s introduce them to the AIUM early in their career.

Philadelphia is the perfect backdrop for connection, exploration, and inspiration. I attend every year not only to stay at the forefront of science, but because the AIUM community truly feels like home.

I hope you’ll check out the program and register today. Together, let’s continue advancing the safe and effective use of ultrasound in medicine—one conversation, one idea, and one connection at a time.

With appreciation and excitement, I invite you to join me.

David Jones, MD, FAIUM
President, American Institute of Ultrasound in Medicine
AIUM member since 1993
Director, University of Vermont Medical Center Fetal Diagnostic Center
Professor of Obstetrics, Midwifery, Gynecology and Reproductive Science
Division of Maternal-Fetal Medicine
Larner College of Medicine
University of Vermont, Burlington

How Ultrasound Helps Detect and Manage Endometriosis

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Ultrasound plays an increasingly important role in the detection and management of endometriosis, a chronic condition in which tissue similar to the uterine lining grows outside the uterus. Although ultrasound cannot identify every form of the disease, it is a valuable, noninvasive tool that helps clinicians recognize certain patterns of endometriosis and guide treatment decisions.

Endometriosis can affect the ovaries, pelvic ligaments, bowel, bladder, and other structures. Symptoms often include pelvic pain, painful periods, pain during intercourse, and infertility. Because these symptoms overlap with many other conditions, imaging is frequently used as part of the diagnostic workup. Ultrasound is usually the first-line imaging test because it is widely available, has a relatively low cost, and does not expose patients to radiation.

One of the most reliable uses of ultrasound in endometriosis is identifying ovarian endometriomas. These are cysts that form when endometrial-like tissue grows within the ovary. They are sometimes referred to as “chocolate cysts” because of their thick, dark fluid content. On ultrasound, endometriomas typically appear as cystic structures with uniform low-level internal echoes and thick walls. This characteristic appearance allows experienced practitioners to recognize them with a high degree of confidence. Detecting an endometrioma strongly suggests the presence of endometriosis elsewhere in the pelvis as well.

Ultrasound can also be used to detect deep infiltrating endometriosis (DIE), which refers to disease that extends into tissues beneath the surface of the pelvic lining. These areas may include the uterosacral ligaments, the space between the uterus and rectum (the pouch of Douglas), and even the bowel or bladder wall. Advanced transvaginal ultrasound techniques can identify nodules, thickened ligaments, and abnormal tissue planes. Sonographers and physicians also assess how pelvic organs move in relation to one another. Limited movement, known as a negative “sliding sign,” may suggest adhesions caused by endometriosis.

In addition to detection, ultrasound is valuable for mapping disease before surgery. Specialized endometriosis-focused ultrasound exams can help determine how far the disease extends and which organs are involved. This information allows surgeons to better plan procedures, anticipate technical challenges, and determine whether additional specialists, such as colorectal surgeons or urologists, may be needed during surgery. Preoperative mapping can improve surgical outcomes and reduce unexpected findings in the operating room.

Despite its strengths, ultrasound has important limitations. It is not effective at detecting superficial endometriosis—small implants scattered across the pelvic lining. These lesions are often too tiny and too flat to be seen on imaging. For this reason, a normal ultrasound does not rule out endometriosis. Laparoscopy with biopsy remains the gold standard for a definitive diagnosis, especially in patients with persistent symptoms and negative imaging studies.

Ultrasound also plays a role in treatment and ongoing management. It can be used to monitor the size of endometriomas over time and evaluate how pelvic anatomy changes with hormonal therapy. In select cases, ultrasound may guide procedures such as drainage of endometriomas or targeted injections for pain management. For patients seeking pregnancy, ultrasound is especially useful for assessing ovarian reserve, tracking follicle development, and identifying anatomic changes that could interfere with conception or fertility treatments.

Overall, ultrasound is best viewed as a powerful tool within a broader diagnostic strategy. It excels at identifying ovarian endometriomas and, when performed by skilled practitioners, can detect many cases of deep infiltrating disease. However, it cannot detect all forms of endometriosis, particularly early or superficial lesions. When combined with clinical evaluation and, when necessary, surgical diagnosis, ultrasound helps clinicians better understand disease extent, tailor treatment plans, and support patients through both symptom management and fertility planning.

In the evolving landscape of endometriosis care, ultrasound continues to grow in importance as a critical piece of the diagnostic and therapeutic puzzle.

Cynthia Owens, BA, is the Publications Coordinator for the American Institute of Ultrasound in Medicine (AIUM).

Seeing the Heart in Motion: A History of Echocardiography

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Ultrasound has become one of the most important tools for examining the heart, but its role in cardiology developed gradually over decades of innovation. What we now know as echocardiography, ultrasound imaging of the heart, has a history rooted in physics, wartime technology, and creative medical problem-solving.

The story begins in the early 20th century with the discovery of ultrasound’s physical properties. Scientists learned that high-frequency sound waves could travel through materials and bounce back when they encountered different surfaces. This principle was first put to practical use in sonar systems during World War II to detect submarines. After the war, physicians began to wonder whether similar sound waves could be used to “see” inside the human body without surgery or radiation.

In the 1950s, this idea reached cardiology. Swedish physician Inge Edler and physicist Hellmuth Hertz were among the first to apply ultrasound to the heart. They adapted industrial ultrasound equipment to record moving structures inside the chest. Instead of producing an image as we know it today, their system created a one-dimensional tracing that showed how heart structures moved over time. This technique, later called M-mode echocardiography, allowed doctors to measure heart chamber size and observe valve motion for the first time in a living patient.

M-mode ultrasound showing echo pattern records of the motion of the anterior leaflet of the mitral valve (left, normal; right, stenosis).
M-mode ultrasound showing echo pattern records of the motion of the anterior leaflet of the mitral valve (left, normal; right, stenosis).

By the 1960s and 1970s, ultrasound technology improved significantly. Two-dimensional imaging replaced simple motion tracings, allowing clinicians to see cross-sectional pictures of the beating heart. These real-time images made it possible to visualize heart chambers, valves, and major blood vessels in motion. Doctors could now assess heart muscle thickness, pumping function, and structural abnormalities without opening the chest or exposing patients to X-rays.

Another major breakthrough came with Doppler ultrasound, which describes how sound waves change when reflecting off moving objects. Doppler techniques made it possible to measure blood flow. Applied to the heart, Doppler ultrasound allowed physicians to determine the speed and direction of blood moving through valves and chambers. This innovation transformed echocardiography from a purely anatomical tool into one that could evaluate function. Conditions such as valve narrowing, valve leakage, and abnormal blood flow patterns could now be identified and measured.

A longitudinal color Doppler image of the carotid artery.
A longitudinal color Doppler image of the carotid artery.

In the 1980s and 1990s, echocardiography became more portable and widely available. Machines grew smaller and more powerful, making it easier to use ultrasound at the bedside, in emergency rooms, and in outpatient clinics. Transesophageal echocardiography, in which a small ultrasound probe is passed into the esophagus, provided clearer images of certain heart structures by placing the transducer closer to the heart. This method proved especially useful for detecting clots, infections of the heart valves, and subtle structural defects.

As computing power increased, digital imaging and advanced processing expanded what ultrasound could show. Three-dimensional echocardiography offered more realistic views of heart anatomy, improving the assessment of valve disease and congenital heart defects. Strain imaging and other advanced techniques made it possible to evaluate how heart muscle fibers deform during each beat, helping detect early signs of disease before major symptoms appeared.

Today, ultrasound is a cornerstone of cardiac care. It is used to diagnose heart failure, guide procedures, monitor treatment, and screen for inherited or structural heart problems. Its advantages, including being noninvasive, radiation-free, and relatively affordable, have made it indispensable across healthcare settings. From large hospitals to small clinics, echocardiography provides critical information that once required far more invasive tests.

The history of ultrasound in heart imaging reflects a broader trend in medicine: the move toward safer, faster, and more informative diagnostic tools. What began as an adaptation of wartime sonar has evolved into a sophisticated technology that reveals the heart in motion, beat by beat. As innovation continues, ultrasound will likely play an even greater role in understanding and protecting one of the body’s most vital organs.

Cynthia Owens, BA, is the Publications Coordinator for the American Institute of Ultrasound in Medicine (AIUM).

5 Ultrasound Trends to Watch in 2026

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1. Autonomous Ultrasound Robots—with Expert Oversight

Autonomous ultrasound robotics are emerging as a potential solution to workforce shortages and access gaps, particularly in rural or underserved settings. These AI-guided robotic systems can position probes, identify anatomical landmarks, and acquire standardized diagnostic views with minimal on-site expertise. Early research shows promising results for consistent image acquisition in areas like abdominal and vascular imaging. (Phys Med Biol 2023 Feb 6;68(4). doi: 10.1088/1361-6560/acaf46 and arXivLabs 2025 Oct 9. doi: 10.48550/arXiv.2510.08106.)

However, it’s critical to emphasize that these systems do not replace clinical experts. While robots may assist with image capture, trained sonographers and physicians are still essential for reviewing images, interpreting findings, and making clinical decisions. In practice, autonomous ultrasound is best viewed as a force multiplier, helping extend expert care to more patients by streamlining acquisition, not eliminating the need for professional judgment.

2. Real-Time 3D Ultrasound Tracking for Interventional Procedures

In interventional radiology and surgical guidance, a next-generation ultrasound innovation is emerging: real-time 3D tracking of instruments using ultrasound. A new system combines B-mode ultrasound with photoacoustic beacons embedded in needles, allowing clinicians to see the exact 3D position of a biopsy needle in real time during procedures (arXivLabs 2025 Dec 18. doi: 10.48550/arXiv.2511.20514). This could dramatically enhance safety, precision, and outcomes in biopsies and minimally invasive therapies.

This could more than improve imaging resolution—it could fundamentally change how ultrasound guides tools during procedures.

3. Ultrasound-Based Neuromodulation and Brain Interfaces

We’re now seeing ultrasound go where it has never gone before, deep into the brain for therapeutic neuromodulation and neurological intervention. One high-profile study showed development of an ultrasound “helmet” capable of targeting very precise brain regions non-invasively, with implications for treating Parkinson’s, depression, stroke recovery, and other conditions traditionally managed with invasive techniques (Nat Commun 2025 Sep 5;16(1):8024. doi: 10.1038/s41467-025-63020-1).

Another ongoing research effort uses focused ultrasound to study human consciousness and explore potential treatments for mental health disorders, a direction of ultrasound research that blurs the line between imaging and direct brain modulation (AXIOS Boston).

4. Low-Cost, Ultra-Flexible Transducer Materials

A cutting-edge materials innovation is producing ultrasound transducers that are both extremely flexible and inexpensive. By integrating porous graphene with 3D-printed piezoelectric polymers, researchers have created flexible ultrasound patches that can be customized in frequency and produce high-quality images, all at very low cost (arXivLabs 2025 Oct 17. doi: 10.48550/arXiv.2510.15737. These could accelerate the adoption of wearable and patch-based imaging technologies beyond prototype labs and into widespread clinical use.

This trend in wearables can help produce more images in different settings.

5. Ultrasound for Non-Invasive Cancer and Tissue Ablation

Although still early in wide adoption, ultrasound therapy is transforming from purely diagnostic to a therapeutic tool that can treat disease directly. Techniques like histotripsy, which uses focused sound waves to mechanically destroy tumor cells without incisions, radiation, or chemotherapy, are already entering clinical practice in some hospitals, with regulatory pathways accelerating adoption (The Times).

This marks a major shift: ultrasound is not just about seeing disease, but treating it in a non-invasive, precise way.

Why These Trends Matter in 2026

What makes these trends stand out beyond incremental improvements is that they represent new functional roles for ultrasound:

  • Autonomy & robotics could solve skill shortage issues.
  • Real-time 3D guidance enhances intervention safety and efficacy.
  • Neuromodulation breakthroughs expand ultrasound into brain therapy.
  • Flexible materials change the economics and form factors of devices.
  • Therapeutic uses like histotripsy redefine clinical treatment paradigms.

Together, these innovations shift ultrasound from a supportive imaging modality to a central tool across diagnostics, therapy, and even autonomous healthcare delivery.

Therese Cooper, MS, RDMS, is a sonographer and the Chief Learning Officer at the American Institute of Ultrasound in Medicine. 

The AIIUM logo.

Interested in learning more about the advancements in ultrasound? Check out these posts from the Scan: