Learning objectives
Demonstrate and explain techniques to optimize needle visualization during US-guided arthrography
Background
US-guided arthrography is a low-cost and radiation-free method of joint injection.
The transducer is placed on the patient’s skin in the appropriate location,
which is indicated by the target and relevant anatomic structures.
Local anesthesia administration follows.
The needle is advanced through the skin and guided to the joint using the in-plane or out-of-plane approach.
Needle visualization could be compromised by the deep location of some joints (e.g.
hip) or because the patient is obese.
Optimal needle visualization is even more important in case of...
Findings and procedure details
There are two methods to direct the needle relative to the transducer and ultrasound beam: the in-plane approach and the out-of-plane approach.
With the in-plain approach,
the needle is inserted parallel to the transducer and the entire needle shaft and tip is visible at all times during the procedure.
The in-plane approach is the preferred method because continual visualization of the entire needle.
Fig. 1 With the out-of-plain approach,
the needle is inserted perpendicular to the transducer and only a short segment of the needle...
Conclusion
Mastering the above-mentioned techniques to optimize needle visualization during US-guided arthrography can help you be faster with a decrease risk of injury to the neighboring soft tissue structures.
Personal information
Timea Hebar
Radiology resident in training.
Department of Radiology,
University Medical Centre Maribor,
Ljubljanska ulica 5,
2000 Maribor,
Slovenia.
Email:
[email protected]
Milka Kljaić Dujić
Msuculoskeletal Radiology Section.
Department of Radiology,
University Medical Centre Maribor,
Ljubljanska ulica 5,
2000 Maribor,
Slovenia.
Email:
[email protected]
References
Adler,
RS (2018).
Musculoskeletal interventions.
In Diagnostic Ultrasound (pp.898–914).
Philadelphia,
USA: Elsevier.
Adler R,
Sofka C.
Percutaneous ultrasound guided injections in the musculoskeletal system.
Ultrasound Q 2003; 19:3–12.
Barr L,
Hatch N,
Roque PJ,
Wu TS.
Basic ultrasound guided procedures.
Crit Care Clin 2014; 30:275–304.
Bruyn GA.
How to perform ultrasound-guided injections.
Best Pract Res Clin Rheumatol.
2009; 23(2):269–279.
Kirschner,
JS (2014).
Introduction.
In Atlas of Ultrasound Guided Musculoskeletal Injections (pp.1–6).
New York,
USA: Springer.
Jacobson,
JA (2013).
Interventional Techniques.
In Fundamentals of Musculoskeletal Ultrasound...