What is the arrow in the image referencing? You guessed it! The Stomach Position – Key to Determining Situs. Let’s talk about why.

When assessing situs in fetal echocardiography, one of the first steps is identifying the location of the fetal stomach. The stomach normally sits on the left side of the fetus (situs solitus). If it’s seen on the right, this suggests situs inversus or heterotaxy, depending on other organ positions.
By combining the stomach position with the heart apex direction and aortic/IVC arrangement, sonographers can confidently determine situs:

• Situs Solitus: Stomach and heart apex both on the left.
• Situs Inversus: Stomach and heart apex both on the right.
• Heterotaxy: Discordant or midline arrangement of abdominal and thoracic organs.

This step is fundamental because situs determination sets the framework for identifying congenital heart disease. Just like recognizing a zero Doppler shift depends on angle, situs depends on orientation landmarks—the stomach is your starting point!

Want to learn more about determining situs? Sign up for our FREE CME course and get 1 SDMS CME Credit for free!

Prevention and Solutions - While the risk is high, WRMSDs are not inevitable. Both individual sonographers and healthcare organizations can play a role in prevention.
Ergonomic Best Practices

• Adjust the patient and equipment height whenever possible.
• Position the machine close to the sonographer to reduce reaching.
• Use chairs with adjustable arm and lumbar support.
• Alternate scanning hands if possible to reduce repetitive strain.

Workplace Policies & Support

• Schedule adequate breaks between exams.
• Rotate assignments to vary physical demands.
• Provide ergonomic training for new and experienced staff.
• Invest in modern equipment designed with ergonomics in mind (lightweight transducers, height-adjustable tables).

Self-Care for Sonographers

• Incorporate stretching exercises before, during, and after shifts.
• Strengthen core and shoulder muscles to support better posture.
• Seek early intervention from occupational health professionals at the first sign of pain.

Why It Matters - Protecting sonographers from WRMSDs isn’t just about personal comfort—it’s about the long-term sustainability of the workforce. With the growing demand for imaging services, healthcare organizations cannot afford to lose skilled professionals to preventable injuries. By prioritizing ergonomics, workplace support, and self-care, we can extend careers, improve job satisfaction, and ensure that patients continue to benefit from high-quality diagnostic imaging.

Musculoskeletal disorders are the silent occupational hazard of sonography—but with awareness, prevention, and support, they don’t have to define your career. 

Now that you've read up on WRMSDs, take our FREE CME course on Sonographer Ergonomics and get 1 SDMS CME credits for free!​

For many years, sonographers have been the unseen backbone of diagnostic imaging, providing critical insights that guide patient care. But while the profession is highly rewarding, it also carries an occupational risk that is often overlooked: workplace-related musculoskeletal disorders (WRMSDs).

The Scope of the Problem - Research shows that more than 80% of sonographers will experience some form of work-related musculoskeletal pain or injury during their careers and many of these can be career-ending. These injuries most commonly affect the shoulders, neck, wrists, hands, and back, and are directly tied to the physical demands of scanning. Left untreated, WRMSDs can lead to chronic pain, reduced productivity, and even force talented professionals to leave the field prematurely.

Causes of Musculoskeletal Disorders in Sonographers - Several factors contribute to the high incidence of WRMSDs in the sonography profession:

• Repetitive Motions – Continuous scanning motions, particularly with transducer pressure, can strain muscles and tendons.
• Awkward Postures – Reaching across patients, twisting the torso, or elevating arms for prolonged periods places stress on the spine and shoulders.
• Forceful Grip – Holding the transducer tightly for stability and precision leads to wrist, hand, and forearm strain.
• Prolonged Standing or Sitting – Fixed positions reduce circulation and increase stiffness, especially in the lower back.
• High Workload & Time Pressure – Back-to-back exams often mean little opportunity for rest or stretching between patients.

Common WRMSDs in Sonography - Sonographers frequently report pain and conditions such as:

• Tendinitis and Tenosynovitis (inflammation of tendons and tendon sheaths)
• Carpal Tunnel Syndrome (compression of the median nerve in the wrist)
• Rotator Cuff Injuries (shoulder pain and weakness)
• Neck and Back Strain (resulting from poor ergonomics and posture)