Ultrasound has limited usefulness when scanning air-filled organs, a reality acknowledged by Natalya Nosenko, a renowned ultrasound diagnostician and head of the center for ultrasound and functional research methods at the Federal Scientific and Clinical Center of the Federal Agency for Medicine and Biology of Russia. Her insights reflect a practical view shared by many clinicians in North America and beyond who rely on ultrasound for real-time evaluation while recognizing its boundaries.
In clinical practice, ultrasound can reveal the architecture of organs and the patterns of blood flow in tissues such as the liver, kidneys, joints, heart, blood vessels, and the thyroid. It remains a versatile tool for guiding procedures and tracking changes over time. Yet, its effectiveness is constrained by physical factors that can limit image quality and diagnostic scope.
According to the expert, certain structures cannot be assessed with ultrasound under current conditions. Images of bone itself, for instance, are beyond the reach of conventional ultrasound because dense skeletal tissue disrupts the sound waves. Soft tissues shielded by bone or metal implants, deep-seated brain regions, and air-containing cavities like the stomach, intestines, and lungs also pose significant obstacles. This is a reminder that ultrasound is best used as a complement to other imaging modalities when examining these regions.
The medical community widely agrees that the biological effects of diagnostic ultrasound are well studied and generally considered safe. However, specific limitations exist when imaging sensitive targets such as the eyes or a developing fetus. In these cases, clinicians follow strict protocols to minimize risk and avoid unnecessary exposure.
Researchers and practitioners emphasize that the imaging programs and equipment in use are designed to adhere to established safety rules. Outside those specially guided scenarios, clinicians can perform a broader number of ultrasound studies, including routine scans, without daily or annual caps, allowing flexibility in monitoring chronic conditions or postoperative recovery.
For clinicians, the key takeaway is to choose the right tool for the right job. Ultrasound offers real-time assessment and safe, cost-effective imaging in many settings. When bone, air, or shielding structures hinder evaluation, alternative imaging modalities like MRI or CT may be preferred to obtain a complete diagnostic picture. As health systems in North America continue to evolve, ongoing research and device improvements promise to expand ultrasound’s utility while maintaining patient safety and comfort.
In clinical practice, questions often arise about how many radiographic studies can be performed within a given period. The consensus among professionals is that the cumulative exposure should be minimized whenever possible, balanced with the diagnostic benefit, to protect patient health over the long term. This approach aligns with principles of responsible imaging care, emphasizing prudence, appropriateness, and the use of shielding and dose optimization techniques when applicable.