Diagnostic imaging embraces several procedures that aid in diagnosing ailments. The most familiar procedures are the x ray and magnetic resonance imaging; however, not all imaging technologies use ionizing, radiation, or radio waves. Sonography, or ultrasonography, is the use of sound waves to generate an image for the assessment and diagnosis of various medical conditions. Sonography is commonly associated with obstetrics and the use of ultrasound imaging during pregnancy, but this technology has many other applications in the diagnosis and treatment of medical conditions throughout the body.
Diagnostic medical sonographers use special equipment to direct high frequency sound waves into areas of the patient's body. Sonographers operate the equipment, which collects reflected echoes and forms an image that may be videotaped, transmitted, or photographed for interpretation and diagnosis by a physician.
Sonographers begin by explaining the procedure to the patient and recording any medical history that may be relevant to the condition being viewed. They then select appropriate equipment settings and direct the patient to move into positions that will provide the best view. To perform the exam, sonographers use a transducer, which transmits sound waves in a cone-shaped or rectangle-shaped beam. Although techniques vary by the area being examined, sonographers usually spread a special gel on the skin to aid the transmission of sound waves.
Viewing the screen during the scan, sonographers look for subtle visual cues that contrast healthy areas with unhealthy ones. They decide whether the images are satisfactory for diagnostic purposes and select which ones to store and show to the physician. Sonographers take measurements, calculate values, and analyze the results in preliminary findings for the physicians.
In addition to working directly with patients, diagnostic medical sonographers keep patient records and adjust and maintain equipment. They also may prepare work schedules, evaluate equipment purchases, or manage a sonography or diagnostic imaging department.
Diagnostic medical sonographers may specialize in obstetric and gynecologic sonography (images of the female reproductive system), abdominal sonography (images of the liver, kidneys, gallbladder, spleen, and pancreas), neurosonography (images of the brain and other parts of the nervous system), or breast sonography. In addition, sonographers may specialize in vascular sonography or cardiac sonography.
Obstetric and gynecologic sonographers specialize in the imaging of the female reproductive system. Included in the discipline is one of the more well-known uses of sonography: examining the fetus of a pregnant woman to track the baby's growth and health.
Abdominal sonographers inspect a patient's abdominal cavity to help diagnose and treat conditions primarily involving the gallbladder, bile ducts, kidneys, liver, pancreas, spleen, and male reproductive system. Abdominal sonographers also are able to scan parts of the chest, although studies of the heart using sonography usually are done by echocardiographers.
Neurosonographers focus on the nervous system, including the brain. In neonatal care, neurosonographers study and diagnose neurological and nervous system disorders in premature infants. Like other sonographers, neurosonographers operate transducers to perform the sonogram, but they use frequencies and beam shapes different from those used by obstetric and abdominal sonographers.
Breast sonographers use sonography to study diseases of the breasts. Sonography aids mammography in the detection of breast cancer. Breast sonography also is used to track tumors, monitor blood supply conditions, and assist in the accurate biopsy of breast tissue. Breast sonographers use high-frequency transducers made exclusively to study breast tissue.
Work Environment
Cardiovascular technologists and technicians held about 58,200 jobs in 2020. The largest employers of cardiovascular technologists and technicians were as follows:
- Hospitals; state, local, and private - 78%
- Offices of physicians - 10%
- Outpatient care centers - 3%
- Medical and diagnostic laboratories - 1%
Diagnostic medical sonographers held about 75,900 jobs in 2020. The largest employers of diagnostic medical sonographers were as follows:
- Hospitals; state, local, and private - 60%
- Offices of physicians - 20%
- Medical and diagnostic laboratories - 11%
- Outpatient care centers - 4%
Diagnostic medical sonographers and cardiovascular technologists and technicians, including vascular technologists, complete most of their work at diagnostic imaging machines in dimly lit rooms. They may perform procedures at patients’ bedsides. Diagnostic imaging workers may be on their feet for long periods and may need to lift or turn patients who are ill or disabled.
Work Schedules
Most diagnostic imaging workers work full time. Some may work evenings, weekends, or overnight because they work in facilities that are always open.
Education & Training Required
There are several avenues for entry into the field of diagnostic medical sonography. Sonographers may train in hospitals, vocational-technical institutions, colleges or universities, or the Armed Forces. Some training programs prefer applicants with experience in other healthcare professions or high school graduates with courses in mathematics, health, and science.
Colleges and universities offer formal training in both 2-year and 4-year programs, resulting in either an associate or a bachelor's degree. Two-year programs are the most prevalent. Coursework includes classes in anatomy, physiology, instrumentation, basic physics, patient care, and medical ethics. In 2008, the Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited over 150 training programs. Accredited programs are offered by colleges and universities. Some hospital programs are accredited as well.
A few 1-year programs that typically result in a vocational certificate also are accepted as proper education by employers. These programs are useful usually only for workers already employed in a healthcare occupation who seek to increase their marketability by training in sonography. One-year vocational-certificate programs are not accredited by the CAAHEP.
Other Skills Required
No States require licensure in diagnostic medical sonography. However, sonographers may become credentialed by one of the professional certifying bodies. Most employers prefer to hire registered sonographers because registration provides an objective measure of an individual's professional standing. To become registered, one must first become eligible to take the examination by completing the proper education, training, or work experience. The exam typically includes a physics and instrumentation exam in a sonography specialty. Typically, sonographers must complete a required number of continuing-education hours to maintain registration. For specific details on credentialing, contact the certifying organization.
The American Registry for Diagnostic Medical Sonography (ARDMS) certifies each person who passes the exam as a Registered Diagnostic Medical Sonographer (RDMS). This credential can be obtained for several different specialty areas like the abdomen, breast, or nervous system. The ARDMS also credentials cardiac and vascular sonographers. The American Registry of Radiologic Technologist offers credentials in breast and vascular sonography. The Cardiovascular Credentialing International credentials cardiac sonographers.
Sonographers should have good communication and interpersonal skills, because they must be able to explain technical procedures and results to their patients, some of whom may be nervous. Good hand-eye coordination is particularly important to obtaining quality images. It is very important that sonographers enjoy lifelong learning, because continuing education is crucial to workers in the ever-changing field of diagnostic medicine.
How to Advance
Sonographers can seek advancement by obtaining competency in more than one specialty. For example, obstetric sonographers might seek training in abdominal sonography to broaden their opportunities and increase their marketability. Sonographers also may seek multiple credentials - for example, being both a registered diagnostic medical sonographer and a registered diagnostic cardiac sonographer.
Sonographers may advance by taking supervisory, managerial, or administrative positions.
Job Outlook
Overall employment of medical sonographers and cardiovascular technologists and technicians is projected to grow 14 percent from 2020 to 2030, faster than the average for all occupations.
About 12,000 openings for medical sonographers and cardiovascular technologists and technicians are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
As the large baby-boom population ages, the need to diagnose medical conditions—such as blood clots and heart disease—will likely increase. Imaging technology is a tool used in making these diagnoses. Moreover, diagnostic medical sonographers, cardiovascular technologists and technicians, and vascular technologists will continue to be needed in healthcare settings to provide an alternative to imaging techniques that involve radiation.
Earnings
The median annual wage for cardiovascular technologists and technicians was $60,570 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $29,910, and the highest 10 percent earned more than $98,070.
The median annual wage for diagnostic medical sonographers was $77,740 in May 2021. The lowest 10 percent earned less than $59,640, and the highest 10 percent earned more than $101,650.
In May 2021, the median annual wages for cardiovascular technologists and technicians in the top industries in which they worked were as follows:
- Outpatient care centers - $78,590
- Medical and diagnostic laboratories - $74,660
- Offices of physicians - $62,220
- Hospitals; state, local, and private - $60,230
In May 2021, the median annual wages for diagnostic medical sonographers in the top industries in which they worked were as follows:
- Outpatient care centers - $100,990
- Hospitals; state, local, and private - $77,770
- Offices of physicians - $77,760
- Medical and diagnostic laboratories - $76,430
Most diagnostic imaging workers work full time. Some may work evenings, weekends, or overnight because they work in facilities that are always open.
