Ultrasound-Guided Interventional Procedures in Pain Medicine

Abstract

Application of ultrasound for musculoskeletal injections is increasingly popular. The common targets for shoulder injection are the subacromial subdeltoid bursa, glenohumeral joint, acromioclavicular joint, and the long head of biceps tendon. This review describes and summarizes the anatomy and sonoanatomy relevant to the injection of these structures. The feasibility, accuracy, and effectiveness of the injections into and around these shoulder structures, as well as the injection techniques, are also described in detail.

A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review

“…The AC joint has multiple anatomic connections with the shoulder [1,2,8,10]. Due to the complex anatomy of the shoulder, the physical examination can be of poor diagnostic value in select patients, especially when coupled with a non-specific history and clinical presentation [1,2,8,10,14,16]. In many instances, clinicians rely on imaging to aid in accurate diagnosis of shoulder pathology.…”

Effect of Intra-articular Hyaluronic Acid Injection on Hemiplegic Shoulder Pain After Stroke

“…The scapular spine was palpated, and the ultrasound probe was placed just caudal and parallel to the lateral end of the spine. A 22-gauge needle was inserted in-plane from the lateral aspect of the probe and directed between the edge of the labrum and the humeral head [17]. To limit the effects of oral pain relievers, single dose of NSAIDs was given to both groups.…”

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

“…The needle is introduced from caudal to cranial until the tip reaches the space interposed between the deltoid muscle and the supraspinatus tendon ( Figure 3B , Video S3 ). 23 …”

“…The needle is introduced from medial to lateral by an in-plane approach until the needle tip pierces the deep fascia of the supraspinatus muscle or the transverse suprascapular ligament ( Figure 5E , Video S5 ). 23 The injectate is instilled into the floor of the supraspinatus fossa.…”