REFLECTION
The shoulder is a complex part of the body to scan. Comparison of the
images taken from the beginning of the semester to those taken mid
semester as well as towards the end of the semester reflects the
practical knowledge gained. Being able to compare the quality of the
images produced has been beneficial in identifying weaknesses with
scanning techniques as well as improving on these techniques from
both practical experience and the theoretic knowledge. One of the
weaknesses identified is that of hesitance in pushing the arm for in
internal and external rotation to check easy gliding of the
glenohumeral joint for possible adhesive capsulitis as well as other
tests such as: Gerber’s test to rule out the subscapularis tear,
Yagasons test to rule out biceps injury, and Hawkins Kennedy test to
test for impingement (Grimshaw 2014). This was overcome by
building confidence and the use of effective communication skills
with the patient in order to determine the source of pain.
Another challenge faced was that of keeping the probe on the skin
surface and trying to avoid anastrophy whilst maintaining
conversation with the patient and keeping an eye on the screen. Over
time, I was able to keep the probe on the skin surface by heel toeing
and with practice; I have been able to multi-task during the
procedure.
Recognition of the pathology in the muscle was another challenge
faced during scanning. Patient history that was gained by asking
them questions such as the kind of work they did or whether they
had suffered direct trauma to the shoulder was an important aspect
in determining the possible pathology. Effective communication as
well as consideration of their comfort during scanning yielded
positive results, as the patient was able to understand that I was
learning. This gave me the confidence to make reference to my notes
as well as the anatomy book when necessary. I also had to be mindful
of my placement of the probe, particularly for viewing the
subscapularis. I had to remember to place the probe in longitudinal
for the transverse view and vice versa.
With more experience in scanning the shoulder, I believe I will be
able to improve on my current knowledge and skills. Being able to
compare my work and identify the improvement in image quality has
been encouraging (especially the improved images of the posterior
shoulder) and has helped me to gain confidence that the quality of
images and diagnosis of pathology will improve significantly with
time.