Abstract
Ultrasound (US)-guided therapeutic and diagnostic injections play an important role in day-to-day clinical practice for many radiologists. When compared with fluoroscopic or computed tomographic (CT) methods of localization, US offers the benefit of real-time confirmation of instrument position without exposing the patient to any ionizing radiation. Target delivery is usually confirmed by direct needle tip visualization and with real-time demonstration of capsular or bursal distention. While often more technically difficult in deeper anatomic spaces, larger patients and smaller delivery needles, US should still be considered the preferred method of image guidance because of these outlined benefits. We present here three cases demonstrating an innovative method of needle-tip position confirmation, termed the “injection jet sign.” This technique represents a useful supplement to routine sonographic guidance and allows the clinician to enjoy the benefits of this imaging modality even in the face of other technical challenges.
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References
Wijesekera NT, Chew NS, Lee JC, Mitchell AW, Calder JD, Healy JC. Ultrasound-guided treatments for chronic Achilles tendinopathy: an update and current status. Skelet Radiol. 2010;39:425–34.
Finnoff JT, Nutz DJ, Henning PT, Hollman JH, Smith J. Accuracy of ultrasound-guided versus unguided pes anserinus bursa injections. PMR. 2010;2:732–9.
Soh E, Li W, Ong KO, Chen W, Bautista D. Image-guided versus blind corticosteroid injections in adults with shoulder pain: a systematic review. BMC Musculoskelet Disord. 2011;12:137.
Curtiss HM, Finnoff JT, Peck E, Hollman J, Muir J, Smith J. Accuracy of ultrasound-guided and palpation-guided knee injections by an experienced and less-experienced injector using a superolateral approach: a cadaveric study. PMR. 2011;3:507–15.
Patel DN, Nayyar S, Hasan S, KhatibO SS, Jazrawi L. Comparison of ultrasound-guided versus blind glenohumeral injections: a cadaveric study. J Shoulder Elb Surg. 2012;21:1664–8.
Hashiuchi T, Sakurai G, Morimoto M, Komei T, Takakura Y, Tanaka Y. Accuracy of the biceps tendon sheath injection: ultrasound-guided or unguided injection? A randomized controlled trial. J Shoulder Elb Surg. 2011;20:1069–73.
Scillia A, Issa K, McInerney K, Milman E, Baltazar R, Dasti U, et al. Accuracy of in vivo palpation-guided acromioclavicular joint injection assessed with contrast material and fluoroscopic evaluations. Skelet Radiol. 2015;44:1135–9.
Naredo E, Cabero F, Beneyto P, Cruz A, Mondejar B, Uson J, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol. 2004;31:308–14.
Finnoff JT, Hall MM, Adams E, Berkoff D, Concoff AL, Dexter W, et al. American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine. Br J Sports Med. 2015;49:151–66.
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Goldschmiedt, J., Shilagani, C. & Patel, H. The “injection jet sign”: an innovative method of needle position confirmation during ultrasound guided injections. Skeletal Radiol 46, 559–563 (2017). https://doi.org/10.1007/s00256-017-2574-0
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DOI: https://doi.org/10.1007/s00256-017-2574-0