Sonographer upper extremity posture and arm strength demands: a simulation study exploring scan location and patient size.

Work-related musculoskeletal disorder (WMSD) rates are increasing among sonographers, with high worker populations reporting pain and discomfort. Upper extremity physical demands and exposures in this cohort are largely unknown, requiring attention to enact changes that mitigate future injury risk. The purpose of this study was to quantify the effects of patient size and scan location on upper extremity postures and joint moment capability of sonographers. An a priori survey was completed by local sonographer staff. Digital human modeling (DHM) of 18 patient avatars and eight scan locations produced 144 scan scenarios. Sonographer exposure assessments were completed using rapid upper limb assessment (RULA) and the arm force field (AFF). The AFF demonstrated that a large subset of scenarios exceeded strength capabilities for 99% of the population. RULA scores of 3 or greater were present across all scans, indicating need for further investigation regardless of patient size and scan location.