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Ultrasound-guided musculoskeletal interventional procedures around the shoulder

Silvia Tortora
Silvia Tortora
, 
Carmelo Messina
Carmelo Messina
, 
Salvatore Gitto
Salvatore Gitto
, 
Vito Chianca
Vito Chianca
, 
Francesca Serpi
Francesca Serpi
, 
Angelo Gambino
Angelo Gambino
, 
Luigi Pedone
Luigi Pedone
, 
Gianpaolo Carrafiello
Gianpaolo Carrafiello
, 
Luca Maria Sconfienza
Luca Maria Sconfienza
 e 
Domenico Albano
Domenico Albano
   | 18 giu 2021
Journal of Ultrasonography's Cover Image
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Article Category: review-article
Pubblicato online: 18 giu 2021
Pagine: 162 - 168
Ricevuto: 03 mar 2021
Accettato: 15 apr 2021
DOI: https://doi.org/10.15557/jou.2021.0026
Parole chiave
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Ultrasound-guided ACJ injection. A. The patient is seated with the arm relaxed, and a high-frequency linear transducer is positioned in the longitudinal plane parallel to the clavicula above the ACJ to visualize the joint space, with needle insertion at the probe midpoint. B. The corresponding ultrasound image shows the needle inserted into the ACJ with the out-of-plane technique; with the corticosteroid (arrowheads) spreading within the joint from the needle tip (arrow)
Ultrasound-guided ACJ injection. A. The patient is seated with the arm relaxed, and a high-frequency linear transducer is positioned in the longitudinal plane parallel to the clavicula above the ACJ to visualize the joint space, with needle insertion at the probe midpoint. B. The corresponding ultrasound image shows the needle inserted into the ACJ with the out-of-plane technique; with the corticosteroid (arrowheads) spreading within the joint from the needle tip (arrow)

Fig. 2.

Ultrasound-guided GHJ injection with the posterior approach and in-plane technique. A. The patient is in prone position, and the transducer is placed on the posterior GHJ recess parallel to the long axis of the infraspinatus muscle. B. The corresponding ultrasound image shows the needle (arrows) introduced in the lateral-to-medial direction and placed into the posterior recess. C. A mixture of a corticosteroid and anesthetic (asterisks) is injected into the GHJ space
Ultrasound-guided GHJ injection with the posterior approach and in-plane technique. A. The patient is in prone position, and the transducer is placed on the posterior GHJ recess parallel to the long axis of the infraspinatus muscle. B. The corresponding ultrasound image shows the needle (arrows) introduced in the lateral-to-medial direction and placed into the posterior recess. C. A mixture of a corticosteroid and anesthetic (asterisks) is injected into the GHJ space

Fig. 3.

Ultrasound-guided GHJ injection with the posterior approach and out-of-plane technique. A. The patient is in prone position, and the transducer is placed parallel to the long axis of the infraspinatus muscle at the level of the posterior GHJ recess. B. The corresponding ultrasound image shows the needle (arrows) inserted into the GHJ space with the most medial part of the humeral head as a target. G – glenoid, H – humerus
Ultrasound-guided GHJ injection with the posterior approach and out-of-plane technique. A. The patient is in prone position, and the transducer is placed parallel to the long axis of the infraspinatus muscle at the level of the posterior GHJ recess. B. The corresponding ultrasound image shows the needle (arrows) inserted into the GHJ space with the most medial part of the humeral head as a target. G – glenoid, H – humerus

Fig. 4.

Ultrasound-guided SASD bursa injection. A. The patient is seated in neutral position, and a high-frequency linear transducer is placed on the shoulder parallel to the long axis of the supraspinatus tendon to visualize the SASD bursa. B. The corresponding ultrasound image shows the needle (arrows) inserted obliquely with the in-plane technique and lateral-to-medial direction, with the needle tip placed into the bursa (asterisks)
Ultrasound-guided SASD bursa injection. A. The patient is seated in neutral position, and a high-frequency linear transducer is placed on the shoulder parallel to the long axis of the supraspinatus tendon to visualize the SASD bursa. B. The corresponding ultrasound image shows the needle (arrows) inserted obliquely with the in-plane technique and lateral-to-medial direction, with the needle tip placed into the bursa (asterisks)

Fig. 5.

Ultrasound-guided percutaneous irrigation of calcific tendinopathy with the single-needle procedure. A. The patient is in supine position, and a high-frequency linear transducer is placed to visualize the calcification in its long axis. B. The corresponding ultrasound image shows the needle (arrows) inserted with the in-plane technique and the calcification (star)
Ultrasound-guided percutaneous irrigation of calcific tendinopathy with the single-needle procedure. A. The patient is in supine position, and a high-frequency linear transducer is placed to visualize the calcification in its long axis. B. The corresponding ultrasound image shows the needle (arrows) inserted with the in-plane technique and the calcification (star)

Fig. 6.

Ultrasound-guided LHBTT sheath injection. A. The patient is in supine position, with the arm in external rotation, and a high-frequency linear transducer is placed in the short axis of the LHBTT to visualize the tendon in the intertubercular groove. B. The corresponding ultrasound image shows the needle (arrows) inserted into the LHBTT sheath (asterisk) with the in-plane approach and lateral-to-medial direction
Ultrasound-guided LHBTT sheath injection. A. The patient is in supine position, with the arm in external rotation, and a high-frequency linear transducer is placed in the short axis of the LHBTT to visualize the tendon in the intertubercular groove. B. The corresponding ultrasound image shows the needle (arrows) inserted into the LHBTT sheath (asterisk) with the in-plane approach and lateral-to-medial direction
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Inglese
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Medicine, Basic Medical Science, other
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