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Hi!
Thank you for your question!
ISUOG has a good guideline on this. From their website:
"Heart. The situs, size and symmetry of the heart should be assessed. The screening examination of the heart involves the four-chamber, outflow-tract and three-vessel-and-trachea views (Figure 2)22. Normal cardiothoracic circumference ratio in the third trimester is approximately 0.45 and should be no greater than 0.50. Mild asymmetry of the ventricles (right > left) and great arteries (pulmonary > aorta) may be normal in the third trimester, but warrants referral for fetal echocardiography if pronounced (Figure 3)22."
https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.27538
Assuming they had a detailed morph scan we are looking for outflow changes which might manifest as asymmetry, VSDs which are easier to see when baby is larger, aliasing in 3VT view for heart block. If they didn't have a morph try to do as much as you can and note within limitations of gestational age.
Please note you need to adhere to your department protocols to be covered by insurance, I would consult with your radiologist/senior if they are unclear.
Women's Health SIG
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Hi,
Thanks for your question regarding CRPS (complex regional pain syndrome). There is not a set protocol for scanning this, as what you need to image will be different depending on where the patient is experiencing pain (which part/s of the body are affected). Requests to image an area for this are rather broad. Sonographers can use their clinical questioning to help ascertain more information from the patient. This can include asking about the nature of the pain - is it constant, intermittent, positional, and where its distribution is. Did the patient have any injury or previous surgery (Nerve pain must be considered as it can account for up to 90% CRPS cases, so knowing your dermatomal distributions of sensory innervation and also what type of motor distribution of different nerves, and all the nerves in the area of interest, and proximal and distal to the area of interest is important.
Sonographically, we will be looking for any structural (static or dynamic) change that can be seen.
Please let us know if you were referring to a particular area of the body, as we can possibly provide a more refined answer.
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Hi Brian,
Thanks for the question. We are just after some more information and context to try and provide you with the correct answer.
Is the GP coming into your practice to perform the injections?
Does the GP perform the injections themselves?
What level of involvement do the sonographers have?
What do you mean about taboo sites that need to be avoided? Do you mean locations that shouldn’t receive cortisone at all or locations such as injecting into the sheath vs tendon ect?
Thanks,
Emma
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Good evening, and thank you for your question.
We've attached some related professional practice guidelines below that you may find useful if you are establishing or reviewing a local protocol.
An example of a department protocol (this is shared as an example of local practice, and is to be considered alongside current professional guidance and local clinical requirements)
For suspected arterial TOS, a combination of duplex ultrasound and physiological testing is performed.
The subclavian artery and axillary artery are assessed within the scalene triangle, costoclavicular space and the retropectoralis minor space. Provocative manoeuvers are applied at all three spaces.
These include - Neutral, ROOS Test, Military brace position, Adsen Test, Modified Adsen, Allen's Test and a Wright Test (you can search these individually for further information). Outside these standard tests, any position that recreates symptoms is also included.
It's important to recognize that neither duplex nor physiological findings should be interpreted in isolation. As positional vascular compression can also occur in asymptomatic individuals, clinical correlation—including whether the patient’s usual symptoms are reproduced—is particularly important.
The central veins are tested with the patient supine to exclude compression and obstruction.
https://www.svu.org/wp-content/uploads/2026/09/Upper-Extremity-Arterial-Duplex-Evaluation-2026.pdf
https://www.svu.org/wp-content/uploads/2026/09/Upper-Extremity-Arterial-Segmental-Physiologic-Evaluations-2026.pdf
https://www.csvs.org.uk/resources/lower-limb-arterial-duplex-assessment/download/
https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2816%2930345-7
Thank you again for your question. Any further questions, please don't hesitate to reach out.
Kind regards,
Vascular SIG