As obesity reaches epidemic proportions, the ability to image and recognize liver pathology in the obese patient has become an essential skill, according to Dr. Jason Birnholz. Fatty liver and liver fibrosis occur in obese patients and sometimes in patients with metabolic syndrome who are not obese, and each has ultrasound imaging features that indicate their presence. Recognizing conditions such as nonalcoholic fatty liver disease is often the first step toward improved health for the patient, and "a routine ultrasound that includes the liver may be the tip-off that the condition is present at a stage when it is treatable," Birnholz writes.

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