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Journaux
Journal of Ultrasonography
Édition 23 (2023): Edition 92 (January 2023)
Accès libre
Ultrasound-guided musculoskeletal interventional procedures around the hip: a practical guide
Domenico Albano
Domenico Albano
,
Salvatore Gitto
Salvatore Gitto
,
Francesca Serpi
Francesca Serpi
,
Alberto Aliprandi
Alberto Aliprandi
,
Luca Maria Sconfienza
Luca Maria Sconfienza
et
Carmelo Messina
Carmelo Messina
| 28 févr. 2023
Journal of Ultrasonography
Édition 23 (2023): Edition 92 (January 2023)
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Article Category:
Review paper
Publié en ligne:
28 févr. 2023
Pages:
15 - 22
Reçu:
27 août 2022
Accepté:
17 nov. 2022
DOI:
https://doi.org/10.15557/JoU.2023.0003
Mots clés
ultrasound
,
hip
,
interventional radiology
,
injections
© 2023 Domenico Albano, Salvatore Gitto, Francesca Serpi, Alberto Aliprandi, Luca Maria Sconfienza, Carmelo Messina, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Fig. 1
Ultrasound-guided hip joint injection. A. The patient is supine, and a convex transducer is positioned parallel to the femoral neck. B. The corresponding ultrasound image shows the needle inserted into the hip joint at the head-neck junction with in-plane technique. H– femoral head; N– femoral neck
Fig. 2
Ultrasound-guided iliopsoas injection. A. The patient is supine, and a linear transducer is positioned in transverse position at the level of the acetabulum to scan the iliopsoas tendon in the short axis. B. The corresponding ultrasound image shows how to insert the needle with in-plane lateral-to-medial approach to reach the deep aspect of the tendon (asterisk). With this approach, the femoral neurovascular bundle (arrow), in the medial aspect of the image, cannot be injured. IP – iliopsoas muscle
Fig. 3
Ultrasound-guided greater trochanter injection. A. The patient is in lateral position on the unaffected side, with a linear probe placed in longitudinal position on the greater trochanter. B. The ultrasound image shows the middle facet of the greater trochanter (T), the insertion of the gluteus medius tendon (asterisk) and the needle that is advanced with in-plane caudal-to-cranial approach to reach the tendon beneath the fascia lata (arrow). GMa – gluteus maximus muscle; GMe – gluteus medius muscle
Fig. 4
Ultrasound-guided hamstrings injection. A. The patient is prone, with the probe being placed in longitudinal position on the ischial tuberosity. B. The needle in inserted with in-plane caudal-to-cranial approach to reach the ischial insertion of hamstring tendons (asterisk). I – ischial tuberosity
Fig. 5
Ultrasound-guided sciatic nerve injection. A. The patient is prone, and the probe is placed in transverse position to scan the sciatic nerve on the posterior aspect of the buttock. B. The sciatic nerve is identified in the ischiofemoral space between the gluteus maximus (superficially) and pelvitrochanteric muscles (deeply and medially), with the needle being advanced with in-plane lateral-to-medial approach. I – ischium; F– femur
Fig. 6
Ultrasound-guided injection of the lateral femoral cutaneous nerve. A. The patient is supine, and the linear probe is in transverse position at the level of the anterior superior iliac spine. B. The needle is advanced with in-plane lateral-to-medial approach to reach the lateral femoral cutaneous nerve (arrow) beneath the inguinal ligament and superficial to the sartorius muscle (S). IP – iliopsoas muscle
Fig. 7
Ultrasound-guided injection of the pudendal nerve. A. The patient is prone, and the linear transducer is placed in oblique position at the level of the ischiatic spine. B. The pudendal nerve (arrow) is identified medial to the pudendal artery (within the circle) between the gluteus maximus muscle (GMa) and the obturator internus muscle (OI). Once identified, the needle can be advanced with in-plane lateral-to-medial approach. I – ischial bone; IS – ischial spine
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