Methods and apparatus for producing a video record of a use of a medical ultrasound system are provided. An ultrasound image video signal and a synthetic display element signal produced by an ultrasound system are encoded as at least one data stream. The at least one data stream is stored in a multimedia container file. The ultrasound video signal and synthetic display element signal may be encoded as different data streams. In some embodiments, the ultrasound video signal and synthetic display element signal are combined in a single video signal, which is encoded as a video data stream. In some embodiments, a subject image video signal is produced by a camera, and this signals is encoded and stored with an associated ultrasound image video signal in a video container.
