Ultrasound-Guided Musculoskeletal Injections

Lin, Jenshan; Gimarc, David; Adler, Ronald S.; Beltrán, Luis; Merkle, Alexander N.

doi:10.1055/s-0041-1740349

Cited by 6 publications

(5 citation statements)

References 65 publications

(258 reference statements)

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“…Physical examination is an integral part of clinical diagnostics 17 18 and has hitherto been the standard method for locating access portals in shoulder and knee arthroscopies. In many outpatient departments and operating theaters, ultrasound is also used on a daily basis as a diagnostic tool and in order to support interventions and operations 13 27 28 . There have been technological advances, and the availability of portable ultrasound units is on the rise.…”

Section: Discussionmentioning

confidence: 99%

Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?

Weimer,

Berthold

et al. 2024

Ultrasound Int Open

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Purpose Arthroscopy is one of the most common interventions in orthopedics. Hence it is important to train users early in order to ensure the safest possible identification of access portals (AP). This prospective study aimed to compare a palpatory (PalpMethod) with a sonographic (SonoMethod) method for AP location in the shoulder and knee joints. Materials and Methods The study included trainee doctors (n=68) attending workshops (lasting approx. 90 minutes). In these workshops a teaching video initially demonstrated the PalpMethod and SonoMethod of AP identification. An experienced operator first marked the access portals on the test subject with a UV pen (determined ideal point [DIP]). Adhesive film was then affixed to the puncture regions. Subsequently participants marked on shoulders and knees first the point determined by palpation, then the point determined by sonography. Analysis involved DIP visualization with a UV lamp and employed a coordinate system around the central DIP. In addition, participants completed an evaluation before and after the workshop. Results The analysis included 324 measurements (n=163 shoulders and n= 161 knees). The majority of participants had not previously attended any courses on manual examination (87.9%) or musculoskeletal ultrasound (93.9%). Overall, the markings participants made on the shoulder using the SonoMethod were significantly closer to the DIP than those made by the PalpMethod (Palp 18.8mm ± 14.5mm vs. Sono 11.2mm ± 7.2mm; p<0.001). On the knee, however, the markings made by the PalpMethod were significantly closer to the DIP overall (Palp 8.0mm ± 3.2mm vs. Sono 12.8mm ± 5.2mm; p<0.001). Conclusion The results show that the SonoMethod produces more accurate markings on the shoulder, while the PalpMethod is superior for the knee.

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Section: Discussionmentioning

confidence: 99%

Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?

Weimer,

Berthold

et al. 2024

Ultrasound Int Open

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“…The SAB thickness was measured using the short axis of the SUP. The measurement technique used for SAB was derived from published articles 10,11 . Normal ultrasound images showed a hypoechoic region between the hyperechoic peribursal fat and the underlying hyperechoic bursal surface of the supra tendon.…”

Section: Methodsmentioning

confidence: 99%

“…The measurement technique used for SAB was derived from published articles. 10,11 Normal ultrasound images showed a hypoechoic region between the hyperechoic peribursal fat and the underlying hyperechoic bursal surface of the supra tendon. This region had a small amount of bursal fluid or thickening (Figure 1C).…”

Section: Measurement Of Sab Thicknessmentioning

confidence: 99%

Diagnostic Implications of Ultrasound Evaluation in Patients With Shoulder Impingement Syndrome

Du,

Wang,

Zhang

et al. 2023

J of Ultrasound Medicine

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ObjectiveTo evaluate the diagnostic value of musculoskeletal ultrasound measurements of subacromial bursa (SAB) thickness, supraspinatus tendon (SUP) thickness, acromiohumeral distance (AHD), and SUP‐to‐AHD ratio (AHD%) in patients with shoulder impingement syndrome (SIS).MethodsThis was a prospective cross‐sectional observational study. Thirty patients with SIS (60 shoulders) admitted between January 2019 and January 2020 were enrolled. The SUP thickness, SAB thickness, AHD, and AHD% (calculated as AHD% = [(SUP / AHD) × 100%]) were measured in 60 shoulders using musculoskeletal ultrasound.ResultsThe affected shoulder displayed thicker SUP and SAB (t = 7.838), narrower AHD (t = 2.324), and larger AHD% (t = 6.875) than the unaffected shoulder (P < .05). The SUP thickness showed a linear positive correlation with AHD (r = .503) and AHD% (r = .792) in the affected shoulder (P < .05). On receiver operating characteristic analysis, AHD*AHD% showed the best diagnostic performance in both measurements (area under the curve: 0.877).ConclusionThis study revealed that SIS symptoms may be related to a larger AHD% with SUP thickening. As diagnostic criteria, the cut‐off values of AHD% (65.6%) and AHD*AHD% (0.504) have good sensitivity and specificity and can help improve the differential diagnosis of patients with SIS.

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“…For certain types of cervical pain injection therapy, there is also evidence that ultrasound provides noninferior guiding effects when compared with computed tomography [ 2 ]. Ultrasonography guidance has many advantages: no ionizing radiation, real-time guidance, high spatial resolution, excellent soft tissue contrast, and the ability to identify and avoid critical structures [ 3 ]. Moreover, shear-wave elastography has recently been introduced on clinical scanners, with a promising role in determining the severity of disease and treatment follow-up of various musculoskeletal tissues, including muscles, nerves, and ligaments [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Proposal of a Route Map for Cervical Spinal Ultrasonography: A Simple and Clear Learning Tool for Beginners

et al. 2023

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Spinal ultrasonography has increasingly been used to image axial structures from the cervical to sacral region in recent years. In this work, we propose a comprehensive, systematic cervical scanning protocol that we refined as a route map, especially for beginners, to facilitate teaching, learning, diagnosis, and treatment in clinical pain practice. As a simple and clear tool to demonstrate the scanning protocol, the route map is delineated with rectangles, lines, and arrows. The rectangles represent the positions of the transducer, the arrows indicate route directions, and the lines show the routes of transducer movement. In this article, we describe cervical spinal ultrasonography to illustrate the route map interpretation, scanning protocol and target anatomical structures in detail. We believe that this comprehensive, clear, systematic, and portable route map will be beneficial for inexperienced pain clinicians and ultrasound beginners.

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Ultrasound-Guided Musculoskeletal Injections

Cited by 6 publications

References 65 publications

Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?

Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?

Diagnostic Implications of Ultrasound Evaluation in Patients With Shoulder Impingement Syndrome

Proposal of a Route Map for Cervical Spinal Ultrasonography: A Simple and Clear Learning Tool for Beginners

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