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Musculoskeletal Sonopathology and Ultrasound-Guided Regional Anesthesia

  • Review Article
  • Published:
HSS Journal

Abstract

The use of real-time ultrasound guidance has revolutionized the practice of regional anesthesia. Ultrasound is rapidly becoming the technique of choice for nerve blockade due to increased success rates, faster onset, and potentially improved safety. In the course of ultrasound-guided regional anesthesia, unexpected pathology may be encountered. Such anomalous or pathological findings may alter the choice of nerve block and occasionally affect surgical management. This case series presents a variety of musculoskeletal conditions that may be encountered during ultrasound-guided regional anesthesia practice.

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Acknowledgment

The authors wish to thank Mr. James Liang, BMSc, Research Fellow, Department of Anesthesia, Toronto Western Hospital, Toronto for his assistance in formatting and editing of images during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Anaesthesia, Glasgow Royal Infirmary, Scotland, UK

    Alan J. R. Macfarlane MBChB, MRCP, FRCA

  2. Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Brian D. Sites MD

  3. Department of Radiology, Lahey Clinic, Burlington, MA, USA

    Vincent R. Sites MD

  4. Joint Department of Medical Imaging of University Health Network and Mount Sinai Hospital, Toronto Western Hospital, Toronto, ON, Canada

    Ali M. Naraghi MD, FRCR

  5. Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA

    John G. Antonakakis MD

  6. Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada

    Vincent W. S. Chan MD, FRCPC, Mandeep Singh MBBS, MD & Richard Brull MD, FRCPC

Authors
  1. Alan J. R. Macfarlane MBChB, MRCP, FRCA
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  2. Brian D. Sites MD
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  3. Vincent R. Sites MD
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  4. Ali M. Naraghi MD, FRCR
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  5. Vincent W. S. Chan MD, FRCPC
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  6. Mandeep Singh MBBS, MD
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  7. John G. Antonakakis MD
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  8. Richard Brull MD, FRCPC
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Corresponding author

Correspondence to Richard Brull MD, FRCPC.

Additional information

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

Level of evidence: level IV: retrospective case series evidence

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Macfarlane, A.J.R., Sites, B.D., Sites, V.R. et al. Musculoskeletal Sonopathology and Ultrasound-Guided Regional Anesthesia. HSS Jrnl 7, 64–71 (2011). https://doi.org/10.1007/s11420-010-9174-z

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  • DOI: https://doi.org/10.1007/s11420-010-9174-z

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