In the 1960s and 1970s, China first introduced ultrasound instruments for clinical examination, and it has been more than 40 years since then. In this short period of 40 years, the rapid development of ultrasound technology has provided us with a lot of clinical convenience and played an important role in the diagnosis of many conditions. From the initial A-type ultrasound, B-type ultrasound, to color ultrasound, to the ultrasound imaging, as well as a variety of ultrasound-guided puncture, interventional procedures, intracavitary ultrasound; from the past mainly used in the abdominal organs, ophthalmology, to now almost used in the whole body, and all clinical departments are closely related to the clinical diagnosis and even treatment are vital. It can be said that ultrasound has become the eyes of clinicians. Clinical visits, open an ultrasound examination application form, has been a very common thing. Even often people come directly to our department to request ultrasound, although against the routine procedures, but also shows that the ultrasound is widely known. It is because ultrasound examination has many advantages such as easy, fast, non-invasive, painless, repeatable, real-time examination, cheap and so on, so it is generally accepted by the people. So as a clinician, how do we choose ultrasound to better detect the patient’s disease? This is what I am going to talk about today, very basic and crucial. I hope it will be helpful to the majority of interns, trainees, and young residents. First, it is important to understand the clinical scope of ultrasound. Although ultrasound can theoretically be applied to the whole body at present, there are great limitations in the application of certain parts, such as the bones of the limbs, lungs, gastrointestinal tract, and head, etc. Combined with the actual situation of our ultrasound department, specifically, our department mainly carries out upper abdomen (including liver, gallbladder, pancreas, spleen, kidney, retroperitoneum, and peri-abdominal aorta), lower abdomen (including ureter, bladder, uterus, ovaries, pelvis), obstetrics thoracic and abdominal pericardial effusion, small organs (including breast, thyroid, testis, parotid, superficial lymph nodes, etc.), soft tissues, extremity vessels, etc. B-mode ultrasound, color Doppler ultrasound, interventional ultrasound, angiography, intracavitary ultrasound and other various examination techniques. Ophthalmology has its own dedicated AB ultrasound, and cardiac examination has a special cardiac ultrasound room. In areas other than that, clinical options such as X-ray, CT, MRI, gastroscopy and other examinations are currently recommended. Secondly, it is important to pay attention to the writing of ultrasound request forms. Many young doctors and even senior physicians seem to pay less attention to this point, because we found many problems from the application form, such as not writing specific age, confusion between men and women, overly simple medical history, random checking of examination items, letting interns write the form without checking and signing, etc. There are even some blank slips without patient’s name, any medical history or examination items for patients to come for examination. Because any examination needs to be combined with the clinical, only if you provide more detailed relevant information, we ultrasonographers may make a diagnosis in line with the real. Otherwise, there is a risk of jokes, mistakes, and even medical errors. I’m not an alarmist, because there is a precedent for this, so I won’t say much here. In fact, it is not easy to write a good list, which also fully reflects the level of your clinical diagnosis. In addition to filling it out carefully (or carefully instructing interns to fill it out), you should also provide as much relevant and important medical history and previous test results as possible, especially those related to ultrasound. They should also learn to understand some ultrasound knowledge seriously, rotate to the ultrasound department as much as possible, and ask for advice from senior doctors or doctors in our department. Only by asking more questions, reading more, and understanding more can you really improve your billing level, and at the same time improve your diagnosis and treatment level. How to choose the type of ultrasound? Whether to choose ultrasound or color ultrasound, whether to perform transabdominal or intracavitary, whether to perform interventional puncture, imaging, etc., should be carefully considered when filling out the project. Generally, ultrasound is preferred for the first examination of the abdominal organs. If the patient is already clinically suspected or diagnosed with a malignant tumor, ultrasound can provide more help. Of course, ultrasound is generally preferred for small organs and blood vessels, as ultrasound provides little information about these diseases. For prostate examinations, especially in elderly patients, endovenous transrectal examinations are preferred; for early pregnancy, early ectopic pregnancy, endometrial disease, and endometriosis, endovenous transvaginal examinations are preferred. Patients who cannot be diagnosed by all kinds of examinations need intervention, puncture biopsy, to obtain pathological results and early diagnosis. Some liver tumors, superficial lymph nodes, and other benign and malignant differentials require contrast examinations. The choice of specific tests is of course crucial, which reflects your diagnostic thinking and plays a decisive role in confirming the diagnosis of the condition. Specifically, patients with trauma should choose ultrasound to examine the abdominal substantial organs (including liver, spleen, kidney, etc.) and thoracoabdominal fluid to observe whether these organs have ruptured bleeding; those with upper abdominal pain need to examine the liver, gallbladder and pancreas to exclude biliary colic, pancreatitis, liver tumors and other disorders; those with low back pain should examine both kidneys and ureters to exclude urinary stones, tumors and other diseases, and those with lower abdominal pain should check gynecological (uterus, ovaries) and pelvic masses to rule out cyst torsion rupture, ectopic pregnancy, acute appendicitis, etc.; cough to check pleural fluid to rule out tuberculous pleurisy, malignant pleural fluid, etc. The application form has been issued, and the next step is to tell the patient how to go for the examination. A general examination requires an appointment time, so you need to inform the patient that he/she needs to go to the ultrasound department to make an appointment, set a price, pay the fee and have the examination. You will most likely write a stack of orders to the patient for blood and urine tests, x-rays, imaging, gastroscopy, ultrasound, etc. Then it is also important to determine the order of the tests. In general, fasting items are checked first, for example, liver, biliary and pancreatic tests require fasting and should be checked first. Special attention should be paid to fasting ultrasound items must be examined before imaging and gastroscopy, otherwise the effect of the examination will be affected. Gynecology, bladder, prostate, etc. require drinking water to keep the bladder properly filled before the examination, and patients should be informed to check these items before laboratory urine tests. Some conflicting items, such as fasting and drinking, should be checked first after fasting and drinking; bladder residual urine examination and bladder and prostate examination, the former requires urine evacuation and the latter requires drinking, so for the accuracy of the examination, you should first evacuate urine for residual urine measurement before drinking. Inform the patient as far in advance as possible to improve the quality of medical services. After the patient has been examined, it is time to analyze the test report. In addition to the ultrasound tips, the descriptions should also be read carefully, which is very important for a specific understanding of the condition. For example, for tumor patients, ultrasound suggests solid occupying lesions, and the description area details the size, morphology, internal echo, boundary, and relationship with surrounding tissues of the mass, all of which are important for clinical management. ultrasound is required for a few patients who cannot determine benign or malignant, further examination of color ultrasound or CT, MRI, or imaging is required. For ultrasound recommendations (such as recommendations for review, recommendations for further examination, etc.), one should follow the recommendations as much as possible, which will give a better grasp of the disease. For some difficult cases, it is necessary to combine various examinations and comprehensive analysis. For those who have doubts about the report, they should contact the examining physician as soon as possible and communicate with him/her in a timely manner in order to understand the condition accurately. The procedure of ultrasound examination is roughly like this. We hope that in the future, the clinic and our department can better cooperate closely to serve the majority of patients and contribute to the development of the hospital.