Shoulder Injections: Ultrasound

2016 ◽  
Author(s):  
Philip W. H. Peng
Keyword(s):  
Real Time ◽  
Acromioclavicular Joint ◽  
Needle Insertion ◽  
Ultrasound Guided ◽  
Accurate Localization ◽  
Long Head Of Biceps ◽  
Long Head

This chapter reviews the anatomy and ultrasound-guided techniques of various shoulder injections, including the glenohumeral joints, subacromial subdeltoid bursa, long head of biceps, and acromioclavicular joint. Ultrasonography is a very useful tool allowing accurate localization of the various target structures for shoulder injections and real-time guidance of the needle insertion. A good understanding of the anatomy and sonoanatomy is of paramount importance in performing the ultrasound-guided injections.

Real-time Ultrasound-Guided Lumbar Epidural with Transverse Interlaminar View: Evaluation of an In-Plane Technique

Pain Medicine ◽  
2019 ◽  
Vol 20 (9) ◽  
pp. 1750-1755 ◽  
Author(s):  
Hesham Elsharkawy ◽  
Wael Saasouh ◽  
Rovnat Babazade ◽  
Loran Mounir Soliman ◽  
Jean-Louis Horn ◽  
...  
Keyword(s):  
Success Rate ◽  
Real Time ◽  
Epidural Anesthesia ◽  
Needle Insertion ◽  
Adult Patients ◽  
Epidural Needle ◽  
Anatomical Landmarks ◽  
Care Hospital ◽  
Open Prostatectomy ◽  
Ultrasound Guided

Abstract Objective The anatomical landmarks method is currently the most widely used technique for epidural needle insertion and is faced with multiple difficulties in certain patient populations. Real-time ultrasound guidance has been recently used to aid in epidural needle insertion, with promising results. Our aim was to test the feasibility, success rate, and satisfaction associated with a novel real-time ultrasound-guided lumbar epidural needle insertion in the transverse interlaminar view. Design Prospective descriptive trial on a novel approach. Setting Operating room and preoperative holding area at a tertiary care hospital. Subjects Adult patients presenting for elective open prostatectomy and planned for surgical epidural anesthesia. Methods Consented adult patients aged 30–80 years scheduled for open prostatectomy under epidural anesthesia were enrolled. Exclusion criteria included allergy to local anesthetics, infection at the needle insertion site, coagulopathy, and patient refusal. A curvilinear low-frequency (2–5 MHz) ultrasound probe and echogenic 17-G Tuohy needles were used by one of three attending anesthesiologists. Feasibility of epidural insertion was defined as a 90% success rate within 10 minutes. Results Twenty-two patients were enrolled into the trial, 14 (63.6%) of whom found the process to be satisfactory or very satisfactory. The median time to perform the block was around 4.5 minutes, with an estimated success rate of 95%. No complications related to the epidural block were observed over the 48 hours after the procedure. Conclusions We demonstrate the feasibility of a novel real-time ultrasound-guided epidural with transverse interlaminar view.

scholarly journals Ultrasound-Guided Percutaneous Tenotomy of the Long Head of Biceps Tendon in Patients with Symptomatic Complete Rotator Cuff Tear: In Vivo Non-contRolled Prospective Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2114
Author(s):  
Luca Maria Sconfienza ◽  
Domenico Albano ◽  
Carmelo Messina ◽  
Salvatore Gitto ◽  
Vincenzo Guarrella ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Biceps Tendon ◽  
Ultrasound Guided ◽  
Cuff Tear ◽  
Ultrasound Monitoring ◽  
Long Head Of Biceps ◽  
Long Head

Background: We prospectively tested technical feasibility and clinical outcome of percutaneous ultrasound-guided tenotomy of long head of biceps tendon (LHBT). Methods: We included 11 patients (6 women; age: 73 ± 8.6 years) with symptomatic full-thickness rotator cuff tear and intact LHBT, in whom surgical repair was not possible/refused. After ultrasound-guided injection of local anesthetic, the LHBT was cut with a scalpel under continuous ultrasound monitoring until it became no longer visible. Pain was recorded before and at least six months after procedure. An eight-item questionnaire was administered to patients at follow-up. Results: A median of 4 tendon cuts were needed to ensure complete tenotomy. Mean procedure duration was 65 ± 5.7 s. Mean length of skin incision was 5.8 ± 0.6 mm. Pre-tenotomy VAS score was 8.2 ± 0.7, post-tenotomy VAS was 2.8 ± 0.6 (p < 0.001). At follow-up, 5/11 patients were very satisfied, 5/11 satisfied and 1/11 neutral. One patient experienced cramping and very minimal pain in the biceps. Six patients had still moderate shoulder pain, 1/11 minimal pain, 2/11 very minimal pain, while 2/11 had no pain. No patients had weakness in elbow flexion nor limits of daily activities due to LHBT. One patient showed Popeye deformity. All patients would undergo ultrasound-guided tenotomy again. Conclusion: ultrasound-guided percutaneous LHBT tenotomy is technically feasible and effective.

Single-Camera Closed-Form Real-Time Needle Tracking for Ultrasound-Guided Needle Insertion

2015 ◽  
Vol 41 (10) ◽  
pp. 2663-2676 ◽  
Author(s):  
Mohammad Najafi ◽  
Purang Abolmaesumi ◽  
Robert Rohling
Keyword(s):  
Closed Form ◽  
Real Time ◽  
Needle Insertion ◽  
Single Camera ◽  
Ultrasound Guided

scholarly journals A Training Program for Real-Time Ultrasound-Guided Catheterization of the Subclavian Vein

2021 ◽  
Vol 8 ◽  
pp. 238212052110258
Author(s):  
Jeffrey D Davis ◽  
Miriam M Treggiari ◽  
Esi A Dickson ◽  
Peter M Schulman
Keyword(s):  
Training Program ◽  
Real Time ◽  
Subclavian Vein ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Skill ◽  
Needle Insertion ◽  
Ultrasound Guided ◽  
Simulated Environment ◽  
Hands On

Purpose: To develop and implement a comprehensive program to train providers to place subclavian central venous catheters (CVCs) using real-time ultrasound guidance. Study design: Simulation-based prospective study at an academic medical center. Of 228 anesthesia providers and intensivists eligible to participate, 106 participants voluntarily enrolled. The training program consisted of a didactic module, hands-on instruction and practice using a CVC simulator and a standardized patient. The success of the program was measured by pre and post knowledge tests and direct observation during the hands-on sessions. Results: Of 106 participants who enrolled, 70 successfully completed the program. Out of 20 possible procedure steps, an average of 17.8 ± 2.9 were correctly performed in the simulated environment. The average time to needle insertion, defined by positive aspiration of stained saline, was 3.35 ± 3.02 min and the average time to wire insertion with ultrasound confirmation was 3.85 ± 3.12 min. Conclusions: Participants learned how to successfully perform ultrasound-guided catheterization of the subclavian vein. Since ultrasound-guided subclavian CVC placement is a useful clinical skill that many practitioners are unfamiliar with, increasing competence and comfort with this procedure is an important goal. Other centers could consider adopting an approach similar to ours to train their providers to perform this technique.

scholarly journals Wide-Awake Shoulder Nanoscopic Long Head of Biceps Tenotomy

2021 ◽  
Vol 10 (3) ◽  
pp. e909-e912
Author(s):  
Chris Peach ◽  
Ronnie Davies ◽  
Nick Phillips
Keyword(s):  
Long Head Of Biceps ◽  
Biceps Tenotomy ◽  
Long Head ◽  
Wide Awake

Study on Clinical Application of Different Ultrasound-Guided Planar Techniques in Minimally Invasive Percutaneous Nephrolithotomy

2021 ◽  
pp. 155335062199779
Author(s):  
Difu Fan ◽  
Leming Song ◽  
Monong Li ◽  
Chunxiang Luo ◽  
Xiaohui Liao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Real Time ◽  
Clinical Application ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Out Of Plane ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Plane Group ◽  
Plane Technique ◽  
Guided Puncture

Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

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