Physical medicine and rehabilitation clinics of North America
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Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma. For each procedure, the indications, relevant anatomy, preprocedural scanning technique, and injection procedure itself are detailed.
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Phys Med Rehabil Clin N Am · Aug 2016
ReviewUltrasound-Guided Interventional Procedures About the Shoulder: Anatomy, Indications, and Techniques.
Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. ⋯ Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures. The purpose of this article is to review common indications and effective techniques for USG injections about the shoulder.
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This article reviews commonly performed injections about the foot and ankle region. Although not exhaustive in its description of available techniques, general approaches to these procedures are applicable to any injection about the foot and ankle. As much as possible, the procedures described are based on commonly used or published techniques. An in-depth knowledge of the regional anatomy and understanding of different approaches when performing ultrasonography-guided procedures allows clinicians to adapt to any clinical scenario.
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Most knee structures can be accurately targeted using ultrasound guidance. These structures are usually superficial, and the overlying soft tissues are mobile and compressible, facilitating excellent visualization with a high-frequency linear array transducer. ⋯ Studies of ultrasonography-guided knee procedures have consistently shown high accuracy, and its use is particularly beneficial for obese patients, diagnostic injection specificity, safety, and precise targeting of pathology. More studies are needed to assess the clinical efficacy and cost-effectiveness of ultrasonography-guided knee procedures.
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Phys Med Rehabil Clin N Am · Aug 2016
ReviewUltrasound-Guided Spinal Procedures for Pain: A Review.
As the population ages, more patients are developing degenerative changes of the spine and associated pain. Although interventional procedures for axial and radicular spine pain have been available for decades, common imaging modalities have relied on ionizing radiation for guidance. Over the past decade, ultrasound has become increasingly popular to image both peripheral musculoskeletal and axial structures. This article reviews the use of ultrasound in the guidance of spine procedures, including cervical and lumbar facet injections and medial branch blocks, third occipital nerve blocks, thoracic facet and costotransverse joint injections, sacroiliac joint injections, and caudal and interlaminar epidural injections.