Soundeffects news | Aaron Fleming (AUS)

Aaron Fleming (AUS)

QScan MUSCULOSKELETAL

Aaron Fleming graduated from radiography at Newcastle University in 2009 and completed a Postgraduate Diploma in Medical Ultrasound in 2013 at QUT. He currently works at Q-scan Red Hill in Brisbane where he is part of a team that provides imaging for a number of elite sporting teams and organisations, including the NRL, AFL and Super Rugby. He was recently involved with imaging for the FIFA Women’s World Cup, as well as other international touring teams. Aaron has presented at a number of ultrasound conferences and his ‘Medial Gastroc vs Plantaris’ lecture was the most viewed at the ASA2023 Brisbane Conference. We ask Aaron about his advice for building confidence as a sonographer and some key takeaways from his upcoming talks at the ASA2024 Sydney Conference.

For sonographers who are new to performing hamstring ultrasound, what advice or recommendations do you have for building proficiency and confidence in this area of practice?

Understand the anatomy of hamstrings, specifically the muscle-tendon units and their ultrasound appearance. Then it’s about developing a methodical and systematic approach to these scans. This will increase proficiency and give you the confidence to scan even the smallest of tears.

What is your approach when confronted with unusual findings or in a situation where you just don’t know where to begin?

Don’t panic. I’ll usually lean on past experiences and cases. I’ll simplify the problem I’m confronted with and ensure the clinical question is answered. It’s important to acknowledge weaknesses and call on the strengths of colleagues when needed.

What do you hope sonographers will learn from your lecture on ‘Quadriceps assessment and injury grading’?

Quadriceps assessment and referrals asking to grade a muscle injury can be intimidating. This presentation will examine the anatomy of the quads and discuss and simplify injury grading systems. We will examine various rectus femoris tears and how best to describe these injuries and will derive an approach that applies to any acute muscle injury scan.

How do you approach differential diagnosis when evaluating sports injuries with ultrasound, particularly when multiple structures may be involved or when the clinical presentation is ambiguous?

Often musculoskeletal and sporting injuries will involve multiple structures and the mechanism of injury will not always be known. I’ll discuss with the patient the injury and their symptoms and then perform a comprehensive ultrasound to provide as much information as possible to the radiologist and referring clinician. This information can be integral to the team that oversees the care and treatment of the patient/athlete and can often dictate return to play times.

What tips can you provide those just beginning their journey into MSK ultrasound? How can collaboration between colleagues enhance knowledge development?

MSK ultrasound can be difficult, especially when starting. Stick with it and be patient and it can become very rewarding. Expand your learning avenues and reach out to colleagues for advice and resources. Collaboration is invaluable and crucial, particularly with MSK development.

Can you tell us about your experience working with the teams for the FIFA Women’s World Cup?

Our department was part of the team that provided imaging for the FIFA women’s World Cup teams in Brisbane. If imaging was required we were on hand to do so. We saw soft tissue injuries of the calf, hamstring and quadriceps which even if low grade are hugely significant in such tournaments. It was a great experience to be part of the radiology team that plays a crucial role in the diagnosis, prognosis and overall management of the athlete.