Australasian journal of ultrasound in medicine
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Australas J Ultrasound Med · Nov 2021
Technique for ultrasound-guided radiofrequency denervation of genicular nerves for chronic knee pain.
Genicular nerve radiofrequency denervation (GNRFD), also called radiofrequency ablation or genicular neurotomy, has been demonstrated to be a safe and effective method of treating and managing chronic knee pain caused by osteoarthritis (OA). The genicular nerves have been identified as key sensory nerves that innervate the knee joint. ⋯ GNRFD is an effective treatment for those with chronic knee pain in whom conservative treatment has failed, who are poor candidates for surgery or who are on an extended waiting list for their surgery. This article outlines the technique for introducing the radiofrequency (RF) probes so the tip is in close proximity to the genicular nerves using ultrasound guidance.
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This is an opinion piece on the role of POCUS in COVID-19, with a focus on lung ultrasound. It is not an instructional essay. Crisis management in medicine has often been likened to crisis management in the aviation industry. ⋯ The COVID-19 pandemic has changed this, clinicians are now faced with the need to make urgent decisions whilst exposed to some personal risk. Whether to embrace POCUS and lung ultrasound during this pandemic is an important decision. Whilst there are clear advantages, poorly considered overzealous uptake it is not without hazard, opportunity cost and potential risk to patient and clinician.
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Australas J Ultrasound Med · May 2020
COVID-US: A simplified approach to cardiopulmonary ultrasound in suspected and confirmed COVID-19 patients in surge crisis.
The severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has placed an unprecedented challenge on healthcare systems across the globe. Rapid assessment of the cardiorespiratory function to monitor disease progression and guide treatment is essential. Therefore, we have designed the COVID-US: a simplified cardiopulmonary ultrasound approach to use in suspected and confirmed COVID-19 patients, to aid front-line health workers in their decision-making in a surge crisis.
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Australas J Ultrasound Med · Nov 2015
Sensitivity, specificity and diagnostic accuracy of novices integrating lung ultrasound into the care of breathless older patients.
Background: Lung ultrasound is frequently used to identify pulmonary oedema, using the 'B line' artefact. A small study in 2011 suggested that novice sonologists had a potential diagnostic accuracy of 85%, when performing the test without reference to other patient information. Aim: We aimed to test the overall diagnostic accuracy of novice clinician sonologists incorporating the 2011 protocol into routine assessment of the patient. ⋯ Novices using ultrasound differentiated between pulmonary oedema and other causes of breathlessness with a sensitivity of 71% (95%CI 44 to 87), Specificity of 91% (76 to 98), a diagnostic accuracy of 85% (72 to 92), a positive LR of 8.2 (2.7 to 25) and a negative LR of 0.32 (0.15 to 0.68). Discussion: The diagnostic accuracy of emergency department clinicians incorporating novice lung ultrasound into the investigation of breathlessness is consistent with the diagnostic accuracy of scanning performed in parallel to patient care, and is likely to be an improvement on current estimates of conventional ED diagnostic strategies. Clinicians should not be afraid that their learning curve would disadvantage the patient.
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Australas J Ultrasound Med · Feb 2014
Ultrasound guided therapeutic injections of the cervical spine and brachial plexus.
Introduction: Recent applications in ultrasound imaging include ultrasound assessment and ultrasound guided therapeutic injections of the spine and brachial plexus. Discussion: Ultrasound is an ideal modality for these regions as it allows accurate safe and quick injection of single or multiple sites. It has the added advantages of lack of ionising radiation, and can be done without requiring large expensive radiology equipment. ⋯ It is important to understand the anatomy and normal variants that may exist to be able to recognise when pathology is present. When pathology is demonstrated it is easy to do a trial of therapy with ultrasound guided injection of steroid around the nerve lesion. This review will outline the normal anatomy and variants and common pathology, which can be amenable to ultrasound guided injection of steroid.