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ultrasound guided musculoskeletal injections

Michael R Baria, Jacob L Sellon, Dan Lueders, Jay Smith
BACKGROUND: There is a growing interest in the use of biologic agents such as platelet-rich plasma and mesenchymal stem/stromal cells to treat musculoskeletal injuries, including meniscal tears. Although previous research has documented the role of diagnostic ultrasound to evaluate meniscal tears, sonographically guided (SG) techniques to specifically deliver therapeutic agents into the meniscus have not been described. OBJECTIVE: To describe and validate SG injection techniques for the body and posterior horn of the medial and lateral meniscus...
January 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Todd P Balog, Blair B Rhodehouse, Eric K Turner, John M Slevin, Lisabeth A Bush, Jason A Grassbaugh, Bryant G Marchant
Intra-articular hip injections have proven clinical value for both diagnostic and therapeutic purposes. Historically, these injections have been performed by radiologists using fluoroscopic guidance. This necessitates a radiology referral, delays the injection, and represents lost productivity for the orthopedist. Ultrasound-guided intra-articular hip injections have been described in the radiology literature with excellent accuracy. These injections were performed by radiologists. The purpose of this study was to determine the accuracy of ultrasound-guided hip injections performed in the orthopedic clinic by orthopedic surgeons and orthopedic physician assistants...
December 19, 2016: Orthopedics
David Kane, Juhani Koski
Aspiration and injection of joints and soft tissues is an indispensable skill used in everyday practice by the clinical rheumatologist. Most rheumatologists recognise that performing these procedures using anatomical landmarks is not always successful, particularly in the case of small or infrequently injected joints, bursae or tendon sheaths. Musculoskeletal ultrasound confirms the local pathological-anatomical diagnosis and is the most applicable and feasible imaging method that can be applied in clinical practice in guiding musculoskeletal interventional procedures...
August 2016: Best Practice & Research. Clinical Rheumatology
Angelique Barreto, Timothy R Braun
OBJECTIVE: The desired therapeutic effect of Arthrokinex™ autologous conditioned serum (ACS) is facilitated by the ability of IL-1-Ra to limit the destructive inflammatory intra-articular (IA) actions of IL-1β. Previous studies have proven the capacity of Arthrokinex™ (ACS) to induce the anti-inflammatory cytokine, IL-1-Ra. The primary purpose of this retrospective study was to investigate the effect of Arthrokinex™ (ACS) to reduce pain, improve joint function and enhance quality of life in patients with knee osteoarthritis...
March 2017: Journal of Orthopaedics
Sherman O Canapp, Debra A Canapp, Victor Ibrahim, Brittany Jean Carr, Catherine Cox, Jennifer G Barrett
OBJECTIVE: To report clinical findings and outcomes for 55 dogs with supraspinatus tendinopathy (ST) treated with adipose-derived progenitor cells and platelet-rich plasma (ADPC-PRP) therapy. METHODS: Medical records of client-owned dogs diagnosed with ST that were treated with ADPC-PRP combination therapy were reviewed from 2006 to 2013. Data collected included signalment, medical history, limb involvement, prior treatments, physical and orthopedic examination, objective temporospatial gait analysis findings, diagnostic imaging results (radiography, magnetic resonance imaging, musculoskeletal ultrasonography), arthroscopy findings, and outcome...
2016: Frontiers in Veterinary Science
Carlos Acebes, John P Harvie, Alison Wilson, Janet Duthie, Fran Bowen, Malcolm Steven
There is no agreement among the rheumatology community in how to implement the musculoskeletal ultrasound (MSUS) technique in the Rheumatology Divisions. To test the perceived usefulness of the MSUS, under consensus indications, for referring colleagues for the clinical management of their patients with inflammatory arthritis (IA) and to score the satisfaction level of the patients with different aspects of the ultrasound (US) examination, after attend to the MSUS clinic. A written questionnaire-based survey regarding the usefulness and satisfaction with the implementation of a pilot MSUS clinic in a Rheumatology Unit...
December 2016: Rheumatology International
E J Martin, E J Cooke, A Ceponis, R F W Barnes, C M Moran, S Holle, T H Hughes, R E Moore, A von Drygalski
INTRODUCTION AND OBJECTIVES: Intra-articular corticosteroid injections are standard of care for managing joint pain secondary to osteoarthritis or rheumatoid arthritis but are rarely used in haemophilic arthropathy. We have introduced and evaluated the efficacy and safety of ultrasound-guided corticosteroid injections for pain relief in patients with haemophilic arthropathy. PATIENTS AND METHODS: Ultrasound-guided intra-articular injections performed on haemophilia patients at UCSD between March 2012 and January 2016 were analysed...
January 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
Evan Peck, Elena Jelsing, Kentaro Onishi
Tendinopathy is increasingly recognized as an important cause of musculoskeletal pain and disability. Tendinopathy is thought to be principally a degenerative process, rather than inflammatory as was traditionally believed. Consequently, traditional tendinopathy treatments focused solely on decreasing inflammation have often been ineffective or even harmful. The advancement of ultrasonography as for guidance of outpatient musculoskeletal procedures has facilitated the development of novel percutaneous procedures for the treatment of tendinopathy, mostly by using mechanical intervention to stimulate regeneration...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Mark-Friedrich B Hurdle
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...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Walter I Sussman, Christopher J Williams, Ken Mautner
High-resolution ultrasonography can help clinicians visualize key anatomic structures of the elbow and guide periarticular and intra-articular injections. Historically, most procedures done around the elbow have been done using landmark guidance, and few studies have reported the accuracy of ultrasonography-guided injections in the elbow region. This article reviews common musculoskeletal disorders about the elbow that can be evaluated with ultrasonography, reviews the literature on ultrasonography-guided injections of the elbow region, and describes the senior author's preferred approach for the most commonly performed elbow region injections...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Ethan Rand, Rachel Welbel, Christopher J Visco
Ultrasound can be used to guide joint and soft tissue interventions to improve accuracy, efficacy, patient satisfaction, and to minimize complications. This article summarizes the rationale supporting ultrasound-guided injections and explains how to safely and effectively set up and perform these procedures.
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Antonio Barile, Alice La Marra, Francesco Arrigoni, Silvia Mariani, Luigi Zugaro, Alessandra Splendiani, Ernesto Di Cesare, Alfonso Reginelli, Marcello Zappia, Luca Brunese, Ejona Duka, Giampaolo Carrafiello, Carlo Masciocchi
This review aims to evaluate the role of anaesthetics, steroids and platelet-rich plasma (PRP) employed with ultrasound-guided injection in the management of musculoskeletal pathology of the extremities. Ultrasound-guided injection represents an interesting and minimally invasive solution for the treatment of tendon and joint inflammatory or degenerative diseases. The availability of a variety of new drugs such as hyaluronic acid and PRP provides expansion of the indications and therapeutic possibilities. The clinical results obtained in terms of pain reduction and functional recovery suggest that the use of infiltrative procedures can be a good therapeutic alternative in degenerative and inflammatory joint diseases...
September 2016: British Journal of Radiology
(no author information available yet)
To combat the prescription opioid problem, St. Joseph's Healthcare System in Paterson, NJ, has developed a new program that gives providers options they can use to effectively alleviate pain without resorting to highly addictive medication. Launched in January 2016 in the ED at St. Joseph's Regional Medical Center (SJRMC), the Alternatives to Opioids (ALTO) program utilizes protocols that primarily target five common conditions: renal colic, sciatica, headaches, musculoskeletal pain, and extremity fractures...
June 2016: ED Management: the Monthly Update on Emergency Department Management
Thøger P Krogh, Torkell Ellingsen, Robin Christensen, Pia Jensen, Ulrich Fredberg
BACKGROUND: Achilles tendinopathy (AT) is a common and difficult to treat musculoskeletal disorder. PURPOSE: To examine whether 1 injection of platelet-rich plasma (PRP) would improve outcomes more effectively than placebo (saline) after 3 months in patients with AT. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 24 patients with chronic AT (median disease duration, 33 months) were randomized (1:1) to receive either a blinded injection of PRP (n = 12) or saline (n = 12)...
August 2016: American Journal of Sports Medicine
Brian D Giordano
OBJECTIVES: Intra-articular hip joint injections have traditionally relied on the use of image guidance to confirm intra-articular needle placement. Musculoskeletal ultrasound (US) has emerged as a popular tool to aid the clinician in performing intra-articular hip injections. Modern automated injection delivery systems are commercially available and may offer the potential to optimize clinical efficiency while limiting procedural morbidity. The purpose of this study was to compare patient-reported outcomes and clinical efficiency between two US-guided intra-articular hip injection techniques...
June 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sanjay Pandey, Hitesh Garg
Parkinson`s disease (PD) is the most common neurodegenerative disease and is characterized by tremor, rigidity and akinesia. Diagnosis is clinical in the majority of the patients. Patients with PD may have stooped posture but some of them develop different types of postural and striatal deformities. Usually these deformities are more common in atypical parkinsonian disorders such as progressive supranuclear palsy and multisystem atrophy. But in many studies it has been highlighted that these may also be present in approximately one third of PD patients leading to severe disability...
January 2016: Indian Journal of Medical Research
Jonathan T Finnoff
Diagnostic and interventional ultrasound is a rapidly evolving field in sports medicine. The use of ultrasound has increased exponentially during the past decades. This imaging modality is appealing to sports medicine physicians because of its broad diagnostic and interventional capabilities. In sports medicine, the indications for diagnostic ultrasound extend well beyond the musculoskeletal realm to include other conditions such as ocular trauma, thoracoabdominal trauma, and cardiac morphology. Thus, the term "sports ultrasound" has been adopted as a more accurate representation of the broad and unique applications of ultrasound in this specialty...
March 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Esperanza Naredo, Annamaria Iagnocco
Musculoskeletal ultrasound (MSUS) has become a relevant part of rheumatology practice and research because it substantially allows us to optimize management of rheumatic and musculoskeletal diseases. This non-invasive imaging modality is a valuable point-of-care tool to accurately evaluate intra-articular and periarticular structures involved in a wide range of rheumatic diseases in adults and children. In addition, MSUS is an invaluable bedside aid for guiding accurate and safe musculoskeletal aspirations, injections and biopsies...
January 2016: Clinical and Experimental Rheumatology
David J Wilson, William F Scully, John M Rawlings
Ultrasound machines are creating more refined pictures and becoming more user-friendly and readily accessible. As a result, ultrasound is being increasingly used for therapeutic purposes. One example involves the use of ultrasound guidance in musculoskeletal interventional procedures, such as joint injections, tendon sheath injections, and peripheral nerve blocks. Technical considerations and therapeutic results have been described for multiple locations about the upper extremities, with varying levels of success...
November 2015: Orthopedics
Verena Constanze Meiser, Helene Kreysa, Orlando Guntinas-Lichius, Gerd Fabian Volk
PURPOSE: First comparison of two methods of needle insertion: long axis ("in-plane") versus short axis ("out-of-plane") approach, each with and without a prototype needle guidance system (NGS). MATERIALS AND METHODS: 24 medical students without prior experience punctured an ultrasound phantom (transparent except for the decklayer) in four conditions, with the goal of achieving as many accurate punctures as possible within a fixed time. RESULTS: Out-of-plane with NGS led to substantially more hits at first attempt than punctures without NGS (p < 0...
September 2016: European Archives of Oto-rhino-laryngology
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