Sonogram vs. Ultrasound — What's the Difference?

Reviewed by Sheetal Chhabra, BS, RDMS, RVT
May 6, 2022

Medical professionals use ultrasound images to diagnose and understand various medical conditions. Sonography can be a rewarding, exciting career field for those interested in working in emergency rooms, hospitals, Ob/Gyn offices and other diagnostic settings.

Sonographers should be prepared to administer ultrasounds to a variety of patients, including men, women and children. Depending on the setting, sonography might take place in time-sensitive situations, like diagnosing an emergency room patient or as an exciting part of a maternity appointment for an expecting mother.

What is a Sonogram?

When a patient receives an ultrasound — whether planned or on an emergency basis — they will see a sonographer. The sonographer will use the ultrasound equipment, including a transducer and processing unit, to scan the patient's abdomen, pelvis or other bodily region and use sound waves to send an image to the attached screen. 

This image — whether of an organ, mass, fetus or other object — can be printed or sent to another professional. It's called the sonogram or the ultrasonogram. Sonogram images are the end result or product created during an ultrasound. When new parents are presented with a picture of their growing fetus, this is a sonogram. Sonograms might be used for diagnosing a condition, tracking a pregnancy, ruling out possible internal concerns or guiding surgeons or equipment during some specialized surgeries. 

As a sonographer, your job will be to use the transducer and ensure it's correctly attached to the ultrasound processing unit. These ultrasound machines are often portable, so you can move them around the room, bed, table or even from room to room. Some sonography setups are even portable outside of the facility on mobile units.


How Are Sonograms Used?

Sonography emits sound waves via an ultrasound machine and transducer probe. These sound waves travel through a patient's body and bounce back when they meet solid tissue, creating white or gray images. The sound waves do not bounce off of liquid, like blood or stomach bile, so those areas of the sonogram image are black.

Once the diagnostic medical sonographer finishes administering the ultrasound, they will save, forward and potentially print the sonogram image from the ultrasound display. They do not interpret nor share any opinion about the image with the patient — that's where a trained radiologist comes in. The radiologist will examine the sonogram image to determine if any abnormalities are present. Sonogram images can also be used to rule out possible conditions, so even a normal image is very useful in diagnostics.

The radiologist shares their findings with the patient's physician or intake doctor — whoever ordered the ultrasound — and the doctor will then use that information to determine the best next steps for diagnosis or treatment.

Are Sonograms Painful?

Sonograms are the live feed or still image an ultrasound produces. The ultrasound itself is not typically painful, though it could be uncomfortable in some situations. It depends on the reason the patient is undergoing the ultrasound, their general health, the sonographer's preparation methods and other factors.

Under ideal circumstances, patients are unlikely to feel an ultrasound at all, aside from the sensation of the transducer gliding over the warm gel.


What is an Ultrasound?

Ultrasounds use high-frequency sound waves and a transducer to send the waves through the body to take images or produce a live feed on the ultrasound display. They allow sonographers and radiologists to see blood vessels, organs, tissues, cysts and other normal and abnormal entities.

Ultrasounds are often used to examine the following:

  • Abdomen
  • Pelvis
  • Heart
  • Blood vessels
  • Pancreas 
  • Uterus
  • Ovaries
  • Testicles
  • Kidneys
  • Chest
  • Breasts

The ultrasound technician will apply a warm gel to the patient's skin and move the transducer across the area they're examining. Some ultrasounds are internal, meaning the technician inserts a special transducer probe into a natural body opening like the vagina or rectum.

What is an Ultrasound Used For?

Ultrasounds can diagnose and rule out several conditions, but medical professionals also use them to perform certain therapies or access areas of the body that are otherwise hard to examine. Examples include:

  • Doppler: Doppler ultrasounds move sound waves through the body's red blood cells to determine how well blood is flowing and whether the frequency or pitch of the blood flow changes as the sound waves move. This method is one way to visualize the heart and blood vessels and diagnose arterial problems, blood clots or valve defects.
  • Elastography: Elastography ultrasounds are specifically for examining the liver for tumors or fibrosis, which can cause tissue to build up as blood flow becomes more limited. This is a serious condition that may lead to liver failure and other fatal or near-fatal complications. This ultrasound uses sound waves to determine the liver's stiffness and tissue density. Some facilities may refer to an elastography ultrasound as a Fibroscan.
  • Musculoskeletal ultrasound: Musculoskeletal ultrasounds are used to examine muscles, tendons, ligaments, joints, and nerves. Doctors can use this procedure to diagnose or rule out a variety of conditions including sprains, arthritis, muscle tears, carpal tunnel, or tendinitis.
  • Therapeutic: Therapeutic ultrasounds are not the same as diagnostic. Instead, they are one component of a larger physical therapy plan for healing injuries or managing symptoms. The heat from an ultrasound can warm tissue and help break up certain cellular formations or speed cellular processes to promote better healing and some pain alleviation. The physical therapist can adjust the ultrasound depth to penetrate deeper, depending on the session goals. Therapeutic ultrasounds are usually used in conjunction with other forms of physical therapy, like the range of motion exercises or treatment medications.
  • High-intensity focused ultrasound (HIFU): High-intensity focused ultrasounds (HIFUs) can target abnormal tissue, like in the case of prostate cancer, and use high-frequency sound wave heat to destroy some of the abnormal or cancerous cells. This is called an MRI-Guided Focused Ultrasound (MRgFUS) or Focused Ultrasound Surgery (FUS). It has fewer side effects than radiation-based cancer treatments and a shorter recovery time. It's also useful for some types of bone metastases or tissue tumors.


Different Types of Ultrasounds

Different types of ultrasounds help medical professionals get a closer look at different areas of a patient's body, including:

  • Abdominal ultrasound: Abdominal ultrasounds are used to assess and diagnose problems with the abdominal organs and structures. This includes the pancreas, liver, gallbladder, spleen, bile ducts, and abdominal aorta. They can also help doctors perform organ biopsies. It's recommended that older men who are current or former smokers undergo an abdominal ultrasound to scan for abdominal aortic aneurysm. For planned abdominal ultrasounds, patients might be asked to fast for several hours before the exam. Abdominal ultrasounds might include all or just some of the abdominal region.
  • Pelvic ultrasound: Pelvic ultrasounds are an extra ultrasound to help diagnose causes of pelvic pain, like fibroids, cysts, fluids, masses or bladder issues. In most cases, a full bladder is needed to perform this ultrasound successfully. Obstetric ultrasound, or OB ultrasound, is the name for pelvic ultrasounds used during pregnancy. They represent one of the most common ultrasound uses. They allow doctors to get a better look at a developing embryo or fetus, predict pregnancy timelines, determine the size of relevant organs or diagnose ectopic pregnancies. Some pelvic ultrasounds are used to locate or inspect intrauterine contraceptive devices (IUDs) and may aid in some biopsies.
  • Transvaginal ultrasound: Transvaginal ultrasounds are internal ultrasounds that use a similar transducer wrapped in a sterile sleeve. This procedure is also called an endovaginal ultrasound. During the procedure, the technician will insert the covered, lubricated transducer into the vaginal canal to diagnose cervical conditions, abnormal bleeding, pelvic pain, ovarian or uterine concerns, placenta position or miscarriage. The patient will need an empty bladder before beginning. 
  • Transrectal ultrasound: Transrectal ultrasounds can diagnose prostate conditions in men. Like the transvaginal ultrasound, the transrectal ultrasound is performed internally with a lubricated, protected transducer capable of achieving different angles. Many doctors use transrectal ultrasounds to perform biopsies and take samples from the rectal lining. Some patients may need to take an enema or emptying solution to clear out the colon and rectum beforehand. The ultrasound transducer is usually carefully inserted as the patient bends their knees toward their chest while laying on their side on the bed.

All ultrasounds produce a sonogram image or live feed, but how those images and recordings are used and which doctors are responsible for interpreting and diagnosing them depends on the unique situation.


Are Ultrasounds Safe?

Ultrasounds are non-invasive and are a safer alternative to radiation. They are also typically safe for those with internal metals, as they involve no magnets. The ultrasound technologist or diagnostic sonographer will apply gel to the examination area to promote better sound flow, and so the transducer will glide evenly across the skin. For internal ultrasounds, the transducer will be covered in a sterile sleeve and adequate lubrication for smooth movements. Though they are safe, medical professionals discourage unnecessary ultrasounds.

Ultrasounds may affect each patient differently, depending on their condition and how prepared they are for the procedure. For example, women undergoing a transabdominal pelvic ultrasound with a full bladder might feel uncomfortable pressure when the transducer presses against their abdomen. Men with prostate pain might feel discomfort during a transrectal biopsy. Standard ultrasounds are usually a fairly quick process, but specialized examinations, like biopsies or other intensive diagnostic imaging, might take longer.

Patients should prepare for their ultrasound to minimize discomfort. Preparation measures include:

  • Wearing comfortable clothes and shoes that are easy to take on and off.
  • Emptying or filling the bladder as instructed.
  • Fasting if necessary.
  • Following all pre- and post-ultrasound instructions.
  • Giving the doctor and technician all relevant information, like preexisting conditions or concerns.

Sometimes, extenuating circumstances may make ultrasounds uncomfortable or painful, like if there is intestinal gas built up or if a patient has a muscular condition that causes pain with internal examinations. These situations aside, ultrasounds are ultimately a very safe and comfortable procedure that takes very little time.


The Difference Between Sonograms and Ultrasounds

The simplest way to understand the difference between sonograms and ultrasounds is to consider the ultrasound the procedure, or process, that creates the sonogram, the final product. You can't get a sonogram without ultrasound equipment, and ultrasounds are useless if they can't produce live feeds or capture images of the target area.

The act of performing an ultrasound to get a sonogram is called sonography, and it's a lucrative field for motivated healthcare individuals looking to play an important role in diagnosis and emergency or non-emergency situations.

While comparing sonograms and ultrasounds is like comparing apples to apple trees, there are several variations of each type. For example, sonogram results may be in print images, digital files or as a live video feed. As you've learned, there are multiple ultrasound types, methods and purposes that generate different sonogram results, depending on the patient, diagnosis and part of the body being analyzed.

Sonography is a critical part of most healthcare operations, especially in hospitals, emergency rooms, Ob/Gyn clinics and cancer centers. While ultrasounds can represent an uncertain or overwhelming time for the patient undergoing the examination, a well-trained sonographer can help ease concerns and make the process go as comfortably and predictably as possible.


Learn More About Our Leading Sonography Programs at AIMS Education

At AIMS Education, our goal is to help you prepare for a long, successful career in the healthcare industry with a focus on building experience both in and out of the classroom. All AIMS Education students studying a career-specific program will complete a clinical internship as part of the completion process, so you'll be prepared for your next chapter with the skills and experience you need to thrive. 

The Diagnostic Cardiac Sonography (DCS) certificate program specifically focuses on cardiac-based ultrasounds and imaging, while the Diagnostic Medical Sonography (DMS) certificate program teaches you what you need to know to understand, interpret and diagnose conditions via sonograms and ultrasound examinations.

Learn more about our healthcare certificate programs or schedule a visit today to prepare for your future sonography career!