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What This Guide Helps With
Troubleshoots degraded ultrasound images, dropout, or intermittent artifact caused by probe condition, coupling, settings, connections, positioning, or environment.
Step-by-Step Troubleshooting
1. Protect Patient Care and Diagnostic Reliability
Do not continue clinical interpretation from an image that is unreliable, significantly degraded, or intermittently missing information.
Move the examination to another verified probe or ultrasound system when image quality could affect diagnosis or procedure guidance.
Expected outcome: Clinical decisions are made using reliable imaging equipment.
2. Reproduce and Characterize the Image Problem
Determine whether the reported condition is:
- General poor image quality
- A fixed dark or missing region
- Intermittent dropout
- Repeating line or band artifact
- Noise throughout the image
- Artifact only with one probe
- Artifact only in one room or location
- Artifact that changes when the cable moves
Use a suitable test object or phantom when available rather than relying solely on patient imaging.
Expected outcome: The artifact pattern and conditions that reproduce it are clearly identified.
3. Inspect the Transducer and Cable
Examine the:
- Acoustic lens
- Probe housing
- Cable
- Strain reliefs
- Connector
Look for cracks, cuts, separation, dents, contamination, fluid intrusion, or cable damage.
Expected outcome: The probe is physically intact. Remove the probe from service if damage could affect electrical safety, acoustic performance, or infection-control integrity.
4. Verify Probe Connection
Confirm the transducer connector is fully and correctly seated.
Inspect accessible connector surfaces for contamination or visible damage.
Expected outcome: The connection is secure and image quality is stable. If reseating corrects the artifact, continue to final verification.
5. Verify Coupling and Test Conditions
Ensure adequate ultrasound gel and appropriate transducer contact are used when reproducing the problem.
When bench testing, use a suitable phantom or test target.
Expected outcome: Poor coupling or test technique is ruled out as the source of image degradation.
6. Check Basic Imaging Controls
Verify that basic user-accessible settings are reasonable for the selected transducer and test target, including items such as:
- Exam or preset selection
- Gain
- Depth
- Focus
- Time-gain compensation or equivalent controls
- Imaging mode
Avoid changing protected configuration or calibration values.
Expected outcome: The image improves when an inappropriate basic setting is corrected, or the artifact remains independent of normal image controls.
7. Compare With a Known-Good Compatible Transducer
Test another known-good compatible probe on the PX under the same conditions.
Expected outcome: If the known-good probe produces a normal image, the issue likely follows the original transducer. If both probes show the same artifact, continue evaluating the system or environment.
8. Compare the Suspect Probe on Another Compatible System
If practical, test the suspect probe on another compatible verified system using comparable conditions.
Expected outcome: The problem either follows the probe or remains with the original PX, providing a clear isolation point.
9. Evaluate Environmental Interference
If the artifact is location dependent, check for nearby equipment or electrical conditions that may contribute to interference.
Compare imaging in another known-good room or power source when practical.
Do not defeat grounding or protective electrical systems.
Expected outcome: Environmental interference is either identified or ruled out.
10. Check for Intermittency During Normal Cable Positioning
While imaging a test object, gently position the transducer cable through normal non-stressed orientations.
Do not sharply bend or intentionally stress the cable.
Expected outcome: Image quality remains stable. Reproducible dropout during normal cable movement supports removal of the affected probe from service.
11. Perform Final Image Verification
After correction:
- Confirm the proper probe is recognized
- Use a suitable phantom or test target
- Verify stable image appearance
- Check multiple basic imaging depths/settings as appropriate
- Confirm no intermittent artifact occurs during normal probe handling
Expected outcome: Image quality is stable and clinically usable. Troubleshooting can stop when the system passes applicable imaging and functional verification.
If the Problem Persists
If coupling, settings, probe condition, probe connection, known-good substitution, and environmental causes have been ruled out, the remaining problem may involve internal signal processing, probe-interface electronics, display processing, system software, or another service-level imaging fault.
The affected system or transducer should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate Fujifilm SonoSite documentation, a suitable phantom, and approved test equipment
- Repaired or configured only by qualified personnel
Do not perform board-level image-path troubleshooting without authorized service procedures.
Complete required imaging-performance and safety checks before return to clinical use.
Knowing when to stop external troubleshooting and escalate is proper troubleshooting.
Clinical Use Tip
Do not dismiss repeatable image dropout as cosmetic; missing image information can affect both diagnostic interpretation and needle or device guidance.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported intermittent vertical image dropout while using the SonoSite PX."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering reproduced the dropout with one transducer and confirmed normal imaging with a known-good compatible probe."
Resolution
What action was taken.
Example:
"Removed the affected probe from service, verified stable imaging with the replacement probe, and returned the ultrasound system to service."
Helpful Details to Include (If Known)
- Type and location of artifact
- Probe used
- Imaging mode
- Preset or exam type
- Whether the artifact was fixed or intermittent
- Probe and cable condition
- Connector condition
- Known-good probe comparison
- Alternate-system comparison
- Room or outlet tested
- Phantom or test target used
- Final imaging result
- Final device and probe status
Final Thought
Poor ultrasound images should be approached by verifying probe condition, coupling, settings, connections, and environment before assuming internal failure. Diagnostic reliability determines when the system must be removed from service.
That is successful troubleshooting.