Factors That Contribute to Wrist-Hand-Finger Discomfort in Diagnostic Medical Sonographers and Vascular Technologists

Abstract

A cross-sectional representative sample of 1722 sonographers and vascular technologists was analyzed using quantitative/qualitative methods to reveal that 60% are experiencing wrist-hand-finger discomfort, believed to be from work-related repetitive injury. The years of scanning accumulated by the participants was chosen as a variable to determine the relationship to the range of discomforts reported. A strong statistical correlation was noted between years of experience and the side of discomfort as well as the severity of hand-wrist-finger discomfort. In this study, a strong statistical association was also noted between increasing years of scanning and decreasing aggravation due to the transducer. A complete linkage between work-related exposure and hand-wrist-finger discomfort is difficult to make because of the contribution of leisure-time activities. A controlled experimental study is needed to determine the contribution that grip and pushing on the transducer may have on the incidence of hand-wrist-finger discomfort, leading to diagnoses such as carpal tunnel syndrome.As has been previously reported, a representative sample of diagnostic medical sonographers and vascular technologists reported that 90% are experiencing discomfort while completing sonography examinations. 1 This represents a potential increase in reports of physical pain compared with previous studies of this typology completed in the 1990s. 2-7 However, because work-related musculoskeletal disorders (WRMSDs) tend to be reported in terms of the frequency per occupational workers, obtaining data at specific anatomical sites may have greater impact. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Diagnostic medical sonographers (DMSs) and vascular technologists (VTs) make use of high-frequency transducers to conduct medical imaging examinations of the human body to collect screening and diagnostic information. 17 Therefore, it is of particular interest to determine to what extent the use and manipulation of the transducer contribute to pain in these occupational workers. Pike et al. 2 provided limited survey information relative to pain at this level, with his cohort reporting 65% of pain in the wrist and 61% in the hand-finger from manipulating the transducer (N = 793).Evaluating the relationship between exposure and WRMSD is extremely difficult, as insults to the wrist/ hand can be acute or chronic as well as having occurred on the job or at home. Because it is challenging to control all exposures to WRMSDs, survey research and observational studies are presently the main method for collecting data information. 18 With extensive data available from a large survey of DMSs and VTs who were asked to provide detailed information about WRMSD, 1 a further analysis of the data set was deemed appropriate to answer a more discrete research question: What factors contribute to WRMSDs in DMSs and VTs who report pain in the area of the wrist-hand-finger?

Work-related musculoskeletal disorders in ultrasound: Can you reduce risk?

“…8,25 Obesity is on the increase 24 and in 2011, the Royal College of Obstetricians and Gynaecologists 26 suggested that approximately 1 in 5 pregnant women were obese, with a BMI of 30. It is important to ensure that limited pressure is placed on the transducer, as pushing can increase transducer grip, which may lead to injury.…”

“…It is important to ensure that limited pressure is placed on the transducer, as pushing can increase transducer grip, which may lead to injury. 25 Techniques that can be used to reduce the risk of muscle injury when scanning obese patients include optimising the equipment, using lower frequency and a range of factors such as harmonics, compound imaging or trying transvaginal scanning, where appropriate. 24 Lifting the panniculus (subcutaneous tissue in the lower abdomen) or scanning from above or to the side of the panniculus can help, 24 as can decubitus scanning or the use of the Sims position, where the patient is almost prone and scanning is from the flank, to reduce the depth of tissue for the sound to penetrate.…”

Work-related musculoskeletal disorders in sonographers: a review of causes and types of injury and best practices for reducing injury risk

“…Some of these symptoms may cause a loss of muscle strength, making it difficult to hold a transducer. [4][5][6]11 Eye strain, although not a symptom of WRMSD itself, can lead to blurred vision and poor posture. As this is a cumulative disorder, seemingly minor symptoms can progress over time to more serious, even debilitating, symptoms.…”

“…11 Gripping the ultrasound transducer contributes to this injury and can lead to "trigger finger," which occurs when the tendon sheath becomes edematous and traps the finger tendon in a locked position. 4,6,[12][13][14] Another form of tendonitis is De Quervain syndrome, which occurs at the base of the thumb and is also associated with gripping the ultrasound transducer department's bottom line, worker morale, and the quality of patient care.…”

Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions

“…an echocardiogram). A patient examination may take 15 to 45 minutes (Evans et al, 2010), depending on the amount of images, measurement and annotation required, as well as challenges posed by the patient’s anatomy. Most exams are performed in outpatient clinics or hospital patient rooms; some are performed in other locations in the hospital.…”