Internal medicine ultrasound diagnostics

In our practice, we perform abdominal and thyroid sonography as a statutory insurance service when a medical indication exists — for example, in unclear upper abdominal complaints, abnormal laboratory values, or clinical suspicion of organ changes. Vascular diagnostics (duplex sonography) and selected extended examinations are offered within the extended internal medicine consultation on Thursdays — fully qualified, but not billable through statutory insurance at our practice seat (see "Vascular Diagnostics" section below).

The examinations are performed with the Samsung V5 ultrasound system — a device that enables not only conventional B-mode sonography but also advanced quantitative techniques such as elastography and color-coded duplex sonography.

Abdominal Sonography

Abdominal sonography is the most important imaging procedure for initial evaluation of abdominal complaints. It is radiation-free, painless, and delivers conclusive findings on upper abdominal organs within minutes.

What is examined?

• Liver: Size, structure, fatty infiltration, focal lesions (cysts, hemangiomas, unclear masses)
• Gallbladder and bile ducts: Gallstones, wall thickening, bile duct dilation
• Pancreas: Signs of inflammation, cysts, ductal changes
• Spleen: Size, structure (e.g., suspected splenomegaly)
• Kidneys and urinary tract: Stones, obstruction, cysts, size asymmetries
• Abdominal aorta: Aneurysm screening (especially in high-risk patients)
• Thyroid: Size, nodules, cysts, echo structure

When is short-notice abdominal ultrasound warranted?

• Unclear upper abdominal discomfort (pressure sensation, nausea, colic)
• Elevated liver values — to clarify the cause
• Suspected gallstones
• Follow-up of known findings (cysts, hemangiomas, fatty liver)
• Abdominal aortic aneurysm screening in men over 65 (covered by statutory insurance once; beyond that as self-pay)
• General abdominal check as part of comprehensive preventive screening

Vascular Diagnostics — Qualifications and Limitations

Color-coded duplex sonography of vessels — particularly the carotid arteries (Arteria carotis), pelvic vessels, and leg veins — is a core area of internal medicine diagnostics. As a specialist in general internal medicine (Facharzt für Allgemeine Innere Medizin), I am fully trained to perform and interpret these examinations and have the appropriate equipment (Samsung V5 with color Doppler and spectral analysis).

Billing of duplex sonography of the neck and pelvic vessels through statutory health insurance is not possible at our practice. The reason is not a lack of professional qualification, but rather the authorization rules of the Association of Statutory Health Insurance Physicians Saxony (KV Sachsen): authorization is tied to specific specialist practice seats that our seat does not cover.

Leg vein compression sonography, however, we perform as a statutory benefit whenever medically indicated — whether suspected DVT, follow-up after thrombosis, venous insufficiency, or unclear leg swelling. If needed, we recommend an additional color-coded duplex sonography as a self-pay service, since this component is not covered by statutory insurance in our practice.

A related ultrasound application is liver elastography for quantitative assessment of fatty liver and fibrosis — see liver diagnostics.

Within the extended consultation on Thursdays (for private patients and self-payers), the following vascular diagnostics are available:

• Carotid duplex: Assessment of intima-media thickness, detection of plaques and stenoses in brain-supplying arteries — an important component of cardiovascular risk stratification
• Pelvic vessels: Visualization of pelvic arteries and veins when suspecting perfusion disorders, stenoses, or venous outflow obstruction
• Additional duplex component of leg veins: beyond compression sonography, to more accurately assess flow patterns.^[1]

Elective workup vs. emergency

The majority of patients seeking leg vein diagnostics are not in an acute emergency situation. Typical scenarios for a planned, elective workup within the extended consultation include:

• Unclear leg swelling persisting for days without acute worsening
• Recurring heaviness or tension after prolonged sitting or standing
• Follow-up examination after previous thrombosis
• Risk assessment before or after long-distance travel
• Screening with known risk factors (thrombophilia, oral contraception, obesity) without acute symptoms

In these cases, timely and thorough diagnostics are warranted — but not on an emergency basis. This is precisely the situation for which we offer leg vein diagnostics within the extended internal medicine consultation.

Services overview

Within which consultation setting?

When a clear medical indication exists for abdominal or thyroid sonography, the examination is performed within the regular consultation as a statutory insurance service. These appointments are bookable via Doctolib.

Duplex sonography of the vessels and selected extended examinations without classical statutory indication take place within the extended internal medicine consultation on Thursdays. This consultation provides the time needed for a thorough history-taking, instrumental diagnostics, and a calm findings review. It is open to private patients as well as self-payers.

If an examination reveals findings requiring treatment, further care is of course provided within standard insurance coverage — including referral to a specialized practice if needed.

If an abnormal finding is present, further treatment and evaluation naturally occurs through regular insurance coverage.