Why Landmarking is the Key to Better Scanning
Jul 08, 2025
Have you ever stared at an ultrasound screen, unsure what you were looking at? That sinking feeling of doubt, the instinct to press harder or wiggle the probe, hoping something recognisable will appear?
You're not alone—and you're not doing anything wrong. In fact, you're closer to a breakthrough than you think.
I want to share a story from a colleague who was scanning a cat. They spotted a large, irregular structure near the stomach—heterogeneous, suspicious—what looked like a splenic tumour. Understandably concerned, they asked me to take a second look. (Spoiler alert: it wasn’t the spleen.) But what really mattered was that familiar feeling they had: Did I miss something? Did I get it wrong?
What Are Landmarks—and Why Do They Matter?
Landmarks are your scanning map. They’re the anatomical signposts that tell you exactly where you are and guide you toward what you’re trying to find. Without them, scanning becomes guesswork. With them, it becomes clinical, calm, and clear.
Most vets think they have a pathology problem or a machine issue—or they blame themselves. But the real issue? Often, they weren’t even scanning the right structure in the first place.
Let me ask you this:
- Have you ever hunted for the right kidney and ended up the panic probe waggle in frustration?
- Wondered if that blurry round shape might be the adrenal? Or a lymph node? Or nothing at all?
That’s what scanning looks like without landmarks. You’re not scanning. You’re searching. And that’s exhausting.
How to Use Landmarks in Real-Life Scenarios
Let’s bring this to life with a few examples. Here are some of the habits I teach in the FOVU Abdominal Scanning Framework that can transform your confidence immediately:
Spleen: Your Confidence Builder
Start from the stomach. Slide dorsally under the costal arch to find the splenic head—tucked between the stomach and left kidney. Trace it to the tail caudally. Same route every time. That repetition builds ultrasound muscle memory.
Pancreas: The Left Limb Triangle
Start with the descending colon. Follow it cranially until it becomes the transverse colon. Now line up the spleen, stomach, and transverse colon—that triangle helps you spot the left limb of the pancreas every time.
Kidneys: Right or Left?
- Check which is more cranial—the left usually is.
- Look at vessel direction: if vessels point away, it’s the side you’re scanning.
- Release the pressure which kidney is closest to your probe now?
Medial Iliac Lymph Nodes: Anchor from the Aorta
Don’t scan blindly near the bladder. Follow the aorta caudally until it splits—your landmark. Nodes sit just lateral to the external iliac arteries. Simple, reliable, repeatable.
From Guessing to Knowing: Why Structure Comes First
Once you’re consistently landing on the right organ, then comes interpretation. That’s where SPEEDS ™ comes in: our FOVU framework to describe findings with confidence:
- Size
- Position
- Echogenicity & Echotexture
- Edge
- Distribution & Dynamics
- Shape and Sampling
But remember: SPEEDS ™ is only useful if you’re on the right structure. And you can’t get there without landmarking.
What Happened With That Cat?
Back to the case. I placed the cat in right lateral recumbency, followed our scanning framework, and found the spleen—normal, smooth, homogenous. Then I moved on: descending colon, transverse colon... and there it was. A mass. But not in the spleen. It was a very abnormal left limb of pancreas. Once in context, it was obvious.
I confirmed with the right side: followed the duodenum to find the right pancreatic limb. Same echogenicity, same pattern. Clear diagnosis, no unnecessary surgery. All thanks to structured scanning.
Ready to Make This Your Habit?
Whether you're just starting our Basics Course, working through Trickier Bits, or already in the FOVU Club, landmarking is the habit that changes everything:
- It gives you a foundation.
- It makes trickier organs findable.
- It sets you up for real, confident interpretation.
So this week, try using three landmark transitions:
- Splenic head from the stomach
- Aorta to the left adrenal
- Stomach–spleen–transverse colon triangle for the pancreas
If you’re ready to put this into practice, we’d love to see your scans and support your progress. Every week, we run FOVU Feedback Friday on Facebook and Instagram—a space to share your images, highlight your landmarks, and get real guidance from the FOVU team.
Here’s how to take part:
- Capture your scan – Take a screenshot of your ultrasound image.
- Mark your landmark – Label the landmark you used (e.g. spleen head, descending colon).
- Submit your image – Use this link to upload your scan and follow the instructions.
- Tag us – Share on Facebook or Instagram using #FOVUFeedbackFriday and tag us so we can see it.
- Get support – We’ll review and offer feedback to help you build confidence and consistency.
It’s all about practise and feedback—because that’s how progress happens.
One Thing to Try This Week
Next time you pick up the probe, pause before diving in. Think: what’s my landmark? Pick one transition—just one—to anchor your scan. Build that habit. Confidence will follow.
Curious About the FOVU Abdominal Scanning Framework?
Want to stop second-guessing and start scanning with more certainty? Our Basics Course walks you through the core landmarks, probe positions, and image interpretations—step by step. It's designed for general practice vets who want a clear structure and the confidence to scan independently.
Show Me More About The Basics Course
And if you're interested in being part of the FOVU Club membership, this is where things really come to life. You’ll get monthly scan prompts, regular live sessions with me, and the chance to post your images for direct feedback. It’s a space to ask questions, share wins, and grow at your own pace—with support and structure every step of the way.
Show Me More About FOVU Club
About Camilla
I’m a first-opinion vet, and I know what it’s like to feel unsure at the screen. That’s why I started FOVU—to help busy vets feel more confident using ultrasound in real consults, even when time is short. Through my signature course The Basics and the FOVU Club membership, I share simple frameworks, ways to practise without pressure, and tips for writing reports you’ll actually feel proud of.
