Ultrasound-guided injection of the elbow: Cadaveric description for the proximal to distal approach
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
36864563
DOI
10.1002/pmrj.12966
Knihovny.cz E-resources
- MeSH
- Injections, Intra-Articular methods MeSH
- Ultrasonography, Interventional methods MeSH
- Latex MeSH
- Humans MeSH
- Elbow MeSH
- Elbow Joint * diagnostic imaging MeSH
- Cadaver MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Latex MeSH
BACKGROUND: Ultrasound (US) guided intra-articular elbow injections are commonly performed in clinical practice. OBJECTIVE: To describe a proximal to distal approach for US-guided intra-articular elbow injection. DESIGN: Cadaveric study. SETTINGS: Academic institution. METHODS: Both elbows of a single cadaver were injected with green-colored water-diluted latex dye using the US-guided proximal to distal approach. In the left elbow, the needle was kept in situ; in the right elbow, the needle was removed. Subsequently, a layer-by-layer anatomical dissection was performed in both elbows. MAIN OUTCOME MEASURES: Presence and distribution of the latex dye and location of the needle tip within the elbow joint capsule. RESULTS: Anatomical dissection of both elbows confirmed the correct intra-articular position of the needle tip in the left elbow as well as correct placement of the latex dye bilaterally. During layer-by-layer dissection of the left elbow, the position of the radial nerve was observed anterior to the needle. CONCLUSIONS: This cadaveric observation demonstrated that the US-guided proximal to distal approach is a convenient technique to access the elbow joint. Compared to the previously described techniques, the in-plane, proximal to distal approach may provide excellent needle visibility during the entire procedure, precisely targeting the articular space. The preliminary data need to be validated in additional clinical studies.
Department of Physical and Rehabilitation Medicine Hacettepe University Medical School Ankara Turkey
Institute of Anatomy 1st Faculty of Medicine Charles University Prague Czech Republic
See more in PubMed
Sussman WI, Williams CJ, Mautner K. Ultrasound-guided elbow procedures. Phys Med Rehabil Clin N Am. 2016;27(3):573-587. doi:10.1016/j.pmr.2016.04.002
Sconfienza LM, Chianca V, Messina C, Albano D, Pozzi G, Bazzocchi A. Upper limb interventions. Radiol Clin North Am. 2019;57(5):1073-1082. doi:10.1016/j.rcl.2019.05.002
van Dam A, van Munsteren C, de Ruiter M. Fix for life. The development of a new embalming method to preserve life-like morphology. FASEB J. 2015;29:547.10.
Ricci V, Abdulsalam AJ, Özçakar L. Ultrasound imaging for dummies: getting oriented among the planes. J Rehabil Med. 2019;51(8):624-625. doi:10.2340/16501977-2581
Özçakar L, Kara M, Chang KV, et al. EURO-MUSCULUS/USPRM basic scanning protocols for elbow. Eur J Phys Rehabil Med. 2015;51(4):485-489.
Ricci V, Güvener O, Chang KV, et al. EURO-MUSCULUS/USPRM dynamic ultrasound protocols for elbow. Am J Phys Med Rehabil. 2022;101(6):e83-e92. doi:10.1097/PHM.0000000000001915
Ricci V, Cocco G, Mezian K, et al. Anatomy and sonographic examination for lateral epicondylitis: EURO-MUSCULUS/USPRM* approach. Am J Phys Med Rehabil. 2022. doi:10.1097/PHM.0000000000002090 online ahead of print.
Mezian K, Naňka O. Non-fresh formaldehyde-embalmed cadaver: not an eligible model for ultrasound guided sacroiliac joint injection studies. Med Ultrason. 2017;19(4):457-461. doi:10.11152/mu-1269
Sun L, Park BK, Gupta S, Capo JT, Yoon RS, Liporace FA. Anatomic variant of the inferior lateral cutaneous branch of the radial nerve during the posterior approach to the humerus: a case report. Patient Saf Surg. 2015;9:16. doi:10.1186/s13037-015-0063-8
Lungu E, Moser TP. A practical guide for performing arthrography under fluoroscopic or ultrasound guidance. Insights Imaging. 2015;6(6):601-610. doi:10.1007/s13244-015-0442-9