Ultrasound-Guided Knee Aspiration and Injection: A Step-by-Step Guide
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- Опубліковано 7 вер 2024
- This video is the ultimate guide to ultrasound-guided knee aspiration and injection. Whether you're a beginner or an experienced practitioner, you'll pick up valuable tips and techniques to improve your skills and optimize patient outcomes.
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ALWAYS use a spinal needle! I learned the hard way that the suprapatellar bursa or recess will collapse during aspiration and you will need to advance or redirect especially if you are following with injection of anesthetic and/or corticosteroid. Early into my initiation in ultrasound it was highly embarrassing to ask the nurse to get a spinal needle while I was in the middle of the procedure. Another thing I find helpful is while holding the probe with my thumb and index finger and anchoring the ulnar or knife edge of my hand on the patient, I'll occasionally use the other three fingers to push the medial aspect of the recess laterally towards me. Because the suprapatellar recess sits like a horseshoe it can be very useful if the recess is small as in the example above. By the way, haven't you seen patients where you are forced to approach medially because that is where the effusion is most prominent? Anecdotally I've encountered it 5% of the time. Thank you again for sharing your process to achieving mastery! Too often I see videos where everything from the body habitus of the patient to needle entry and visualization is perfect. Nonetheless, this MSK US was utterly cool.
Is this true for shoulder calcium barbotage too? I mean always using a spinal needle part
@@jayetachoudhury8945 No because with barbotage you are essentially using the syringe as a plunger to break up the calcium deposit in the supraspinatus tendon but not distending or decompressing a joint recess as you do in the knee. One bit of caution is young athletes often have huge deltoid muscles which makes it necessary to use a spinal needle to reach the glenohumeral joint or subacromial subdeltoid bursa.
Great stuff. Invaluable in my fellowhship training!
Fantastic, and authoritative as always
Great idea on the 20 gauge and guiding the needle. I have used 25 gauge. Now I know why I have had so much trouble seeing it.
fantastic
Excellent
Thank you so much 😀
very nice
Excellent ❤
Thanks!
Which coupling agent is the safest?
Is ultrasound gel sterile?
i guess its depend on the product, my hospital use filling u/s gel so definitely isnt sterile.
No! Sterile gel comes as a single use packet in the sterile probe cover kit or Surgilube brand 3g packets. Of course, with the latter you must have an assistant apply gel for you or you apply it yourself but then don sterile gloves for the injection