In office ultrasound testing is a valuable adjunct to the physical exam, especially in the evaluation of pelvic pain. We have a screen set up on the ceiling so that you can see what Dr Holley is seeing, understand the structures and images. You can also participate in the study by pointing out areas that are tender, moving or coughing to encourage organs to slide against each other, or even standing up if necessary to see exactly what is causing your problem.
We use a vaginal probe for most studies as it is more accurate than a trans abdominal ultrasound, and allows better resolution in most cases. If a uterine mass is encountered, a small amount of saline can be placed in the uterus through a tiny catheter. This is called sonohysterography, and it allows us to differentiate between fibroid tumors and uterine polyps. We can also assess the patency of the fallopian tubes using this technology.
Younger girls and elderly ladies may not be able to tolerate a vaginal probe ultrasound, and we have an abdominal probe available to do ultrasound studies for them as well.
We also have a 12 mega hertz transducer for the evaluation of breast lesions and superficial skin structures. When a Nexplanon contraceptive implant cannot be palpated, we can often find it using the ultrasound transducer designed for skin and superficial structures. If a breast lesion is identified, we can biopsy it under ultrasound guidance confirming that the lesion was adequately removed.