363S.N. Narouze (ed.), Atlas of Ultrasound-Guided Procedures in Interventional Pain Management, DOI 10.1007/978-1-4419-1681-5, © Springer Science+Business Media, LLC 2011

AAcromio-clavicular (AC) joint

anatomy, 298–299ultrasound-guided technique

visualization, transducer, 299, 300“walk-down”, 299

Adham, M.N., 317Anterior superior iliac spine (ASIS)

IH nerve, 209level, right groin, 351LFCN, 252, 280ultrasound probe, 212

Armstrong, T., 309Arora, R., 317Articular process of the facet joints (APFJ), 169Arzola, C., 150ASIS. See Anterior superior iliac spineAtlanto-axial and atlanto-occipital joints

anatomy, 354clinical presentation, 353ultrasound-guided injection

imaging, 354, 356long-axis sonogram, vertebral artery, 356longitudinal midline scan, 354short-axis sonogram, vertebral artery,

355, 356transducer, 354, 355

Attenuationaverage degree, 18vs. beam frequency, 26cause, ultrasound acoustic beam

degradation, 52description, 52ultrasound waves, 15

Avci, S., 316Awad, I.T., 239

BBa ekim, C.C., 186Balki, M., 175Ben-Ari, A., 138Berman, L., 327Bertrand, M.L., 37, 44, 48, 65Bhatia, A., 279

Biceps tendon sheathanatomy

long head, 297short head, 297

clinical presentation, 297ultrasound-guided technique

bicipital groove injetion, 297, 298“in plane” approach, 298long head, 297

Bittar, R.G., 338Blike, G.T., 37, 44, 48, 65Bloc, S., 69Bodenham, A.R., 67Bodner, G., 120, 126Bodor, M., 307, 311Boesen, M., 313Bogin, I.N., 162Brull, R., 21Brull, S.J., 55Bruyn, G.A., 320Buchanan, K., 47

CCaglar-Yagci, H., 327Campos, N.A., 43Carpal tunnel injections

anatomyCTS, 308FDS, FDP and FPL, 308

ultrasound-guidedaccuracy, needle placement, 310vs. blind, 309CTS, 309long-axis technique, 309needle insertion site and target distance, 310nerve function, 309short-axis technique, 309

Casaletto, J.A., 317Caudal epidural injection

blind technique, 181indications, 180limitations, 180literature review, 180–181ultrasound-guided technique, 181–183

Index

364

Index

Celiac plexus block and neurolysisanatomy, 200, 201anterior percutaneous approach, 201levels, 200–201pain syndromes, 199percutaneous ultrasound-guided

echoic falciform ligament, 205ram-horn-like appearance, 204sagittal scan, 204xiphoid process, 201, 203

retrocrural technique, 200sonoanatomy

distal esophagus, 203tiny nerve fibers, 202

Central neuraxial blocks (CNB)description, 162education and training

spinal sonography and sonoanatomy, 176USG interventions, 175

evidence, 175imaging modalities, 162spine ultrasound imaging

lumbar spine, 168–169neuraxial structures, 163sacrum, 165–168scan axis, 163–164spinal sonoanatomy, 164–165thoracic spine, 170–171water-based spine phantom, 165

ultrasound-guidedcaudal epidural injection, 172central neuraxial structures, 171loss-of-resistance, 173lumbar epidural injection, 173–174spinal injection, 175thoracic epidural injection, 174

Cervical diskographyfluoroscopy, limitation, 360neck pain and degenerative disk disease, 359ultrasound-assisted technique

cervical spine level, 361fluoroscopy, 361scout scanning, 361ultrasonography, 360

Cervical medial branch blockadvantages, 110anatomy, 107–108indications, 108–109level identification

articulation, 114bony surfaces, 113caudal cervical medial branches, 111–112C2-3 zygapophysial joint, 111facet joint C2-3, 111transducer position, 112–113transverse processes, 114

limitations, 110practical performance

relation needle, 114–115TON, 115ultrasound probe, 114vulnerable structures, 116

ultrasound-guided facet nerve block, 109–110Cervical nerve root block

anatomy, 125–126indications, 126

limitations, 126literature review, 126–127sonoanatomy

anterior tubercle, 127lateral decubitus position, 127–128seventh cervical transverse process, 127

ultrasound-guided technique, 128–130Cervical spine (CS), sonoanatomy

deepacoustic window, 94C4 and C7, 95cervical part, VA, 96transverse scan, atlanto-axial space, 94ventral rami, 96vertebral artery (VA), 95

superficialAAJ and AOJ, 91, 92atlanto-occipital and atlanto-axial windows, 90, 91C4 and C5 vertebral bodies, 94greater occipital nerve (GON), 91,occipital bone, 90TON and medial branches, 92, 93transverse processes, C5 and C6, 93

Cervical sympathetic blockanatomy, 274anterior paratracheal approach, 274“bone contact and needle withdrawal”, 276deviation, esophagus, 275inferior thyroidal artery, 275–276prevertebral region, neck, 274SGB, 273ultrasound-guided injection

internal jugular vein, 276–277neck at C6, 277sixth cervical vertebral level, 277

Cervical sympathetic trunk (CST)blockade, 276location, 274

Cervical zygapophyseal joint intra-articular injectionindications, 120lateral approach, 120literature review, 120posterior approach

prone position and bilateral injections, 120sagittal longitudinal scan, 121sagittal longitudinal sonogram, 122

Chan, C.W., 207Chantzi, C., 71Chan, V.W., 13, 175Chapman, G.A., 67Chen, C.P., 172, 180Cheng, J.K., 184Chiles, J.H., 43Chin K.J., 175Choudhary, S., 316Chronic pelvic pain (CPP)

ilioinguinal (II), iliohypogastric (IH) and genitofemoral (GF) nerves

anatomy, 209–210literature review, 210–211ultrasound-guided technique, 211–214

neural blockade, 208pathophysiology, 208piriformis syndrome

analgesic pharmacotherapy, 215anatomy, 215–216

365

Index

literature review, 216sciatica, 214ultrasound-guided technique, 217–218

pudendal neuralgiaanatomy, 218–219anterior and posterior urogenital areas, 218literature review, 219ultrasound-guided technique, 220

surrogate markers, 208Chronic regional pain syndrome (CRPS), 308Clendenen, S.R., 55CMC joint of thumb, 315Colburn, N., 47Colio, S., 307Comet tail artifacts (CTAs), 289Compound spatial imaging, 53Cone beam CT (CBCT)

invasive spine procedures, 6surgical applications, 5utilization, 7

Conradi, R., 163, 170, 171, 173, 174Continuous peripheral nerve blocks (CPNB)

applications, 260catheters, 260electrical nerve stimulation guidance, 260perineural catheter

insertion, 260–262preparation, 262surgical procedures, 263–268

Cork, R.C., 162, 163Costello, J.F., 175CPNB. See Continuous peripheral nerve blocksCravero, J., 36, 37CST. See Cervical sympathetic trunkCTAs. See Comet tail artifacts

DDavis, G.A., 338de Quervain's tenosynovitis, 316–318Dhonneur, G., 69Digital subtraction angiography (DSA), 3, 4Dimitriou, V., 71

EEcoffey, C., 69Eichenberger, U., 107Eisenberg, E., 338Elbow injection technique

anatomybursae, 319description, 319nerve, 319

ultrasound-guidedaspiration, 321long-axis, 320–321pain diagnosis and treatment, 319–320

Emerman, C., 47Eustace, J.A., 301

FFeinglass, N.G., 55Finucane, B., 71Flat detector computed tomography (FDCT)

accuracy and safety, 5fluoroscope gantry, 5pain procedures, 5peripheral nerve stimulation, 10polymethylmethacrylate cement, 6

Fleischmann, M., 9Flossman, T., 311Fluoroscopically confirmed patellofemoral approach, 334Fluoroscopically guided technique, 360Fonda, B.J., 126Fox, K., 293French, R., 175Frequency compound sonography, 53Fuchs, S., 313

GGaliano, K., 120, 126, 157Gallagher, J.D., 37, 44, 48, 65Ganapathy, S., 71Ganglion impar block

anatomy, 183indications, 183limitations, 183–184literature review, 184ultrasound-guided, 184–185

Glenohumeral jointanatomy, 299–300blind approach limitations, 301pathology, 300–301rotator interval approach, 301–303ultrasound-guided technique

humeral head rolling, 301injection, 301posterior view, transducer, 301

Godey, S.K., 311Gofeld, M., 149Goldschneider, K.R., 6Gosch, M., 9Grassi, W., 309Grau, T., 150, 163, 170, 173, 174Greater occipital nerve (GON) stimulation. See Occipital

neurostimulationGreengrass, R.A., 55Greher, M., 151, 165Groin neurostimulation, ultrasound-guided

description, 349ilioinguinal and iliohypogastric nerves, 350ilioinguinal/iliohypogastric PNS lead implant

IOM and TAM, 350, 351short-axis sonogram, 351

limitation, 350vs. PNS, 350

Gruber, H., 157, 199

HHalaszynski, T., 35Heran, M., 6Hip injections

blind techinque limitations, 326intra-articular, 326joint anatomy, 326ultrasound-guided

color Doppler sonography, 327, 328femoral head and neck, 327, 328

366

Index

Hip injections (cont.)hydrolocalization, 329intra-articular, 327linear array transducer, 327scout scan, 327, 328sonography, 327

Hoeft, M.A., 126Honma, E., 175Horter, J., 163, 170, 173, 174Hsu, T.C., 172, 180Hsu, Y.W., 184Huntoon, M.A., 4, 125, 337Hurdle, M.F.B., 331

IICN. See Intercostal nerveIlfeld, B.M., 259Ilioinguinal (II), iliohypogastric (IH) and genitofemoral

(GF) nervesanatomy, 209–210literature review, 210–211ultrasound-guided technique, 211–214

Impingement test, 296Im, S.H., 332Inferior oblique muscle (IOM), 346Intercostal nerve (ICN) block

analgesia, rib fractures, 285anatomy, 286injection techniques, 286–287ultrasound-guided block technique,

287–289Interventional pain management

C-Arm FDCTcapability, 63D imaging system, 5hypogastric plexus blocks, 6target bony structures, 5

color Dopplerpain procedures, 29radial artery view, 30stationary transducer, 29

compound imaging, 31depth setting, 23–25focus

focal zone, 27level setting, 28optimize lateral resolution, 26

free button and image acquisition, 33frequency and probe selection, 22–23gain, 25–26optimization button, 32power Doppler, 30–31presets, 28time gain compensation, 26tissue harmonic imaging, 32ultrasound

chronic pain procedure, 7–8epidural blocks, 9imaging techniques, 10–11intra-articular injections, 8sympathetic blocks, 9–10trigger point and muscular injections, 8US and CT/fluoroscopy, 10zygapophyseal and medial branch

blocks, 8–9Irwin, D.M., 149

JJackson, D.W., 331Jeyapalan, K., 316Johnson, D., 67Jones, A., 301, 331

KKamolz, L.P., 165Kappis, M., 199, 201Kapral, S., 9Karafa, M., 47Karmakar, M.K., 133, 161Kasuya, Y., 151Kim, B.J., 180Kim, S.J., 180Kim, W.S., 180Kiralp, M.Z., 186Knee injections

limitationsblind injections, 331–332hyaluronic acid, 331

ultrasound-guidedfluoroscopic confirmation, 333lateral patella and needle, 333medial patellar approach, 333–334pouch effusion, 333short-axis approach, 333suprapatellar and lateral pouches effusion scanning, 332–334

Knight, J.R., 6Koetsveld-Baart, C.C., 109Koh, S.B., 180Koski, J.M., 313Krafft, P., 9Kropelin, B., 71

LLateral femoral cutaneous nerve (LFCN)

blockanatomy, 280–281injection techniques, 281ultrasound-guided block technique, 281–282

blockade, 252, 253Leipold, R.W., 163, 170, 173, 174Leopold, S.S., 326Lerman, I., 35Lesher, J.M., 307LFCN. See Lateral femoral cutaneous nerve“Lift off test”, 303Lim, J.B., 302Lin, C.S., 184Lister's tubercle, 314Liu, D.M., 6Localization, procedure needle

agitated solutions/ultrasound contrast agentscontrast agents, 70–71microbubbles injection, 69–70

basic sonographic effect, enhancementlow acoustic impedance, 66vessel wall, 67

hydrolocalization, 68–69nerve stimulation, 71priming, insertion and vibration

algorithm, 68color flow Doppler, 67, 68

Lohman, M., 313

367

Index

Louis, L.J., 320Lower limb, ultrasound-guided nerve blocks

ankledeep peroneal nerve block, 257peripheral nerves, 255posterior tibial nerve block, 257preparation and positioning, 256

femoral nerveanalgesia and anesthesia, thigh and knee, 241anatomy, 241continuous catheter technique, 244femoral triangle, relation, 242inguinal region, transverse scan, 243in-plane and out-of-plane approach, 247, 248preparation and positioning,241single-injection technique, 243

lateral femoral cutaneousanatomy, preparation and positioning, 252ASIS, 252in-plane approach, 252

linear and curvilinear probe, 241lumbar plexus/psoas compartment

anatomy, 248in-plane and out-of-plane technique, 250low-frequency curved array probe, 249preparation and positioning, 249sciatic nerve blockade and, 248transverse processes, 248

needle tip, visualization, 240obturator nerve

anatomy, preparation and positioning, 251high-frequency linear array probe, 247“3-in-1” technique, 250transverse image, upper thigh, 251

positioning, operator, 241saphenous

anatomy, 253–254in-plane and out-of-plane approach, 254paravenous injection, 254preparation and positioning, 254and sartorius muscle, 254thigh, cross section, 253

sciaticin-plane and out-of-plane approach, 245low-frequency curved array probe, 245posterior thigh and lower leg, anesthesia and analgesia, 244preparation and positioning, 244–245sacral plexus, 244transverse scan, 246

sciatic nerve blockade, popliteal fossaanatomy, 246–247high-frequency linear array probe, 247in-plane and out-of-plane approach, 247lower leg, anesthesia and analgesia, 246needle repositioning, 248popliteal nerve, vein and artery, 247preparation and positioning, 247

Lumbar nerve root (periradicular) injectionslimitations, 301lumbar radiculopathy, 157ultrasound-guided technique, 158–159

Lumbar spine (LS)deep

lumbar root L3, 102maximum flexion, 102vertebral canal, 101

ligamentum flavum, 169, 170

spinous process, 169superficial

articular and costal processes, 100dorsal surface, 101hypo-to anechoic gap, 100LZJ entrances, 101mamillary and accessory processes, 99spinous process (SP) and inferior articular process (iAP), 100

transverse sonogram, 168–169Lumbar zygapophysial (facet) nerve block

anatomy, 150injection technique

limitations, 156longitudinal scanning, 154lumbar vertebra, 154–155lumbosacral segment, 154out-of-plane approach, 154transducer positioning, 155

literature review, 150–151scanning technique

articular and transverse processes, 154axial position, 154bony protuberance, 151hyperechoic signal, 151–152lumbar lordosis, 151lumbar vertebra, 153paramedian position, 152

Lundberg, J., 37Luyet, C., 136, 137

MMacfarlane, A.J.R., 21Mandl, L.A., 313Mariano, E.R., 259Martin, E.O., 163, 170, 173, 174McCartney, C.J.L., 239McShane, J.M., 317Median nerve, 340–341Mimura, M., 175Mishra, A., 317Monsey, R.D., 126Moriggl, B., 79Motsch, J., 163, 170, 173, 174Mulchandani, H., 239Munk, P.L., 6

NNamiki, A., 175Narouze, S.N., 119, 125, 126, 179, 193, 199, 345, 349,

353, 359Needle-probe alignment, visibility

advanced positioning systemscombined ablations, 64freehand technique, 62oblique and out-of-plane approach, 63sensors, 63

“ART”, scanning, 64biplane approach, 61ergonomics

freehand technique, 65marking, skin, 66operator fatigue, 66

“in-plane” (IP) and “out-of-plane” (OOP) approachdisadvantage, 58insertion, needle, 58–59

368

Index

Needle-probe alignment, visibility (cont.)mechanical and optical procedure guides

adjustable, 61Tsui device, 62

need of, 58oblique plane approach, pain management, 60

Needle visibilityacoustic impedance

body tissues, 43variations, 43

adequate mentorship, trainingdidactic categories, 37local anesthetic injection, 37

basic sonography and needle image interpretation“echo”, 42ultrasound transducer, 42

combined ultrasound and flouroscopic phantom simulatorscervical transforaminal injections, 40, 42manual dexterity, 40–42tracking skills, 39

echogenic procedure needlesdisadvantage, 47indentations/notches, 45–46low-frequency generator, installation, 47neurostimulation properties, 49polymer coated vs. nonechogenic needle, 48–49

enhancement and techniques, localizationagitated solutions/ultrasound contrast agents, 69–71hydrolocalization, 68–69nerve stimulation, 71priming, insertion and vibration, 67–68sonographic effect, 66–67

high-fidelity simulationeZONO device, 41multimedia tools, 39simulator phantoms, 39U-GRASP IT, 38–39, 41

needle-probe alignmentadvanced positioning systems, 62–64“ART”, scanning, 64biplane approach, 61ergonomics, 65–66IP and OOP approach, 58–60mechanical and optical procedure guides, 61–62need of, 58oblique plane approach, pain management, 60

phantomsATS laboratories, 40blue, 39cervical spine water bath, 40description, 37“fidelity”, 38–39surgical gel pad, 39tofu, 38water bath, 38

positioning, 36procedure needle tip

bevel up vs. bevel down, 48, 50errors, trainees, 48Havels echogenic, 51versatility, 50

procedure, ultrasound imaging artifactsanisotropy, 51attenuation, 52refraction, 52reverberation, 51–52

scattering, 51, 52specular reflection, 52

shaft and tip, 36size/gauge and echogenicity

21 G and 18-G needle, 44large gauge (G) needle, 43

skin insertion site and angle of procedurebehavioral training, 43curved vs. linear probe, 46, 47decreased visibility, 43–45echogenic needles, 45“heel in” maneuver, 44perpendicular angle, 44

sonographic modes, impactbeam steering, 52–53brightness, motion and Doppler modes, 54, 55compound spatial imaging, 52–533D and 4D ultrasound imaging, 54–57frequency compound, 53time gain compensation and harmonic imaging, 54ultrasound probe, frequency, 53–54

ultrasound imaging and, 57–58Neer and Hawkins–Kennedy impingement tests, 295“Neuropathic pain”, 339Nishiwaki, K., 138

OObwegeser, A.A., 120, 126“Occipital field stimulation”, 347Occipital neurostimulation (ONS)

anatomy, 346limitations, 346ultrasound-guided, lead implant

fluoroscopic confirmation, 347headache disorders, 345vs. PNS, 347short axis sonogram, 347SSC and IOM, 346, 347

“Occipital PNS”, 347ONS. See Occipital neurostimulationO'Riain, S.C., 138, 145Osteoarthritis (OA)

classification, 313hip, 325

PParaskeuopoulos, T., 71Peacock, W.F., 47Pekkafahli, M.Z., 186Peng, P.W.H., 125, 126, 208, 273, 280“Perineural” catheter insertion

nerve in long axis, needle in-planelong-axis imaging, 262visualization, target nerve, 261

nerve in short axis, needle in-plane approach, 260, 261nerve in short axis, needle out-of-plane

placement needle, 261short-axis imaging, 261

preparationstandard perineural catheter equipment, 262sterile technique, 262

surgical procedures, CPNBfemoral, 264–265infraclavicular, 264

369

Index

interscalene, 263–264popliteal sciatic, 267–268subgluteal sciatic, 265–266tranversus abdominis plane, 268

Peripheral nerve blockade, pain managementICN

anatomy, 286injection techniques, 286–287neurolytic ICNB, 285ultrasound-guided block technique, 287–289

LFCNanatomy, 280–281injection techniques, 281ultrasound-guided block technique,

281–282SSN

and branches, 283injection techniques, 283–285left shoulder, muscle layers, 283notch, 284supraspinatous fossa, 283ultrasound-guided block technique, 285

USPM, 280Peripheral nerve stimulation (PNS)

analgesia neurolysis, 338anatomical consideration, 339description, 337–338etiologies, 338median

description, 340Martin-Gruber anastomosis, 340–341neural fascicular communications, 340stimulation, 341

patient selection and neurolysis analysis, 339peroneal, neuroma, 338posterior tibial, 343radial

description, 339–340vascular structures, 340

sciatic, opliteal bifurcationperoneal nerve, 341ultrasound scanning, 341–342

ulnar, 340uses, historical, 338

Perlas, A., 13, 175, 227Phantoms. See also Needle visibility

description, 37“fidelity”, 37–38

Phelan, M.P., 47Piriformis syndrome

analgesic pharmacotherapy, 215anatomy, 215–216literature review, 216sciatica, 214ultrasound-guided technique, 217–218

Plunkett, A.R., 43“Popeye” arm, 297Posterior tibial nerve, 343Pourbagher, M.A., 327Pudendal neuralgia

anatomy, 218–219anterior and posterior urogenital areas, 218literature review, 219ultrasound-guided technique, 220

“Pulse echo principle”, 43Pusch, F., 137

RRaabe, R., 6Racadio, J.M., 6Radial nerve, 339–340Radiofrequency ablation (RFA), 116Rafi, A.N., 194Ramlogan, R., 175Rathmell, J.P.,126Rauch, S., 151Real-time and image interpretation support system (eZONO), 41Riazi, S., 227Riutort, K.T., 55Robinson, P., 326Rotator interval approach, 301–303Rutten, M.J., 301

SSacroiliac joint (SIJ) injection

anatomy, 185–186indications, 186literature review, 186

Sacrumanterior acoustic shadow, 166prone position, 165sonoanatomy, 165–166

Sacrum and sacroiliac joint, sonoanatomydeep

bony floor, sacral canal, 104, 105sacroiliac diarthrosis, 105

superficialdorsal sacral foramina, 104dorsal surface, 103sacral crests, 103sacral hiatus, 104

Salini, V., 313Saranteas, T., 71“Scarf ” test, 299Schaefer, M.P., 293Scharbert, G., 165Sethi, P.M., 301SGB. See Stellate ganglion blockShankar, H., 325Shibata, Y., 138Siegenthaler, A., 107Simhan, S., 325Sim, K.H., 181Sites, B.D., 37, 43–44, 48, 65“SLAP lesion”, 297Sluijter, M.E., 109Smith, J., 309Sofka, C.M., 327Sonoanatomy

cervical spinedeep, 94–96superficial, 90–94

lumbar spinedeep, 101–102superficial, 99–101

sacrum and sacroiliac jointdeep, 104–105superficial, 103–104

thoracic spinedeep, 98superficial, 96–98

Souzdalnitski, D., 35

370

Index

“Speed” test, 297Spence, B.C., 37, 43–44, 48, 65Spine anatomy

cervical spine (CS)anterior and posterior view, 81atlanto-occipital (AOJ) and atlanto-axial joints (AAJ), 82, 83bilateral ribs, 82cervical zygapophysial joints (CZJ), 82intervertebral foramina, 80, 81sonoanatomy, 90–96transverse processes (TP), 80uncinate processes, 82

lumbar spine (LS)antero-lateral view, 87lateral view, 86, 87lumbar zygapophysial joints (LZJ), 86, 88lumbosacral joint (LSJ), 87mamillary and spinous processes, 86posterior view, 85sonoanatomy, 99–102

sacrum (S)dorsal surface, 90isolated, 88lateral and median sacral crest, 89posterior superior iliac spine, 89in situ, dorsal view, 89sonoanatomy, 103–105

thoracic spine (TS)costal process (CP) and spinous processes (SP), 82, 83costotransverse joints, 84, 85posterior view and lamina (LAM), 84sonoanatomy, 96–98thoracic zygapophysial joints (TZJ), 83

SSN. See Suprascapular nerveStellate ganglion block (SGB)

paratracheal approach, 273sympathetic blocks, 9–10

Sternoclavicular (SC) jointanatomy, 304clinical presentation, 304–305ultrasound-guided technique

visualization, 305–306“walk-down”, 305

Stulin, I.D., 162Subacromial/subdeltoid bursa

anatomy, 295clinical presentation, 295indications, 295limitations, 295ultrasound-guided technique

dynamic assessment, 296imaging, 295, 296injection, 296sonographer, 296

Subscapularis tendon and bursaanatomy, 303clinical presentation, 303ultrasound-guided technique

imaging, bicipital groove, 303injection, 304

Superior articular process (SAP), 150, 153, 155Superior costotransverse ligament (SCL)

fibroelastic structure, 134internal intercostal muscle, 141lateral portions, 136

linear echogenic bands, 138TPVS, 142transverse process, 136ultrasound visibility, 143

Suprascapular nerve (SSN) blockanatomy, 282–283injection techniques, 283–285ultrasound-guided block technique, 285

TTakahashi, E., 175Tang, S.F., 172, 180Teddy, P.J., 338Tendon dysfunction

de Quervain's tenosynovitis, 316, 318impingement, 317intersection syndrome, 316lateral epicondylitis (LE)

description, 316317platelet-rich plasma (PRP) injections, 317, 318

ultrasound-guided techniquede Quervain's tenosynovitis, 317FPL impingement, 317, 319lateral epicondylitis, 317tendon impingement, 317

Third occipital nerve (TON)C2-3 zygapophysial joint, 111fluoroscopically guided technique, 115hypothesis, 109oval hypoechoic structure, 109superficial medial branch, 108

Thoracic paravertebral block (TPVB)anatomy

endothoracic fascia, 134–135fibroelastic structure, 134vertebral column, 134

mechanism, 136sonoanatomy

chronic pain procedure, 138high-frequency linear transducer, 139intertransverse ligaments, 140sagittal sonogram, 139spatial resolution, 143ultrasound imaging, 144

techniques, 136ultrasound-guided

anatomy, 137high-frequency linear transducer, 138in-plane technique, 138surface anatomical landmarks, 137transverse process, 137

USG techniquesparamedian oblique sagittal scan, 144–145short-axis needle insertion, 144transverse scan, 145–146

Thoracic spine (TS)deep

T11 and T12, 98T4/T5 and T5/T6, 98visualization, 98

narrow interspinous spaces, 170neuraxial structures, 170–171sagittal sonogram, 171superficial

371

Index

costotransverse joints, 97transverse processes, 96–97

Transversus abdominis plane (TAP) blockanatomy

classic approach, 194muscle layers, 194ultrasound-guided technique, 194–195

lumbar abdominal afferents, 193peripheral nerve blockade, 194

Transversus abdominus muscles (TAMs), 350Triamcinolone acetonide (TA), 313Trigger finger injections

anatomydescription, 311first annular (A1) pulley, 311

ultrasound-guided techniqueA1 pulley, 311–312long-axis, 311short-axis, 311

True shoulder joint. See Glenohumeral jointTse, C.C.H., 21, 227Tsui, B.C., 61, 71Turan, A., 151

UUGIP. See Ultrasound-guided interventional proceduresU-GRASP IT. See Ultrasound-guided regional anesthesia simulation

phantom interactive toolUlnar nerve, 340Ultrasound-guided block technique

ICNCTAs, 289in-plane technique, 288intercostal muscles and pleura, 288linear transducer, 287

LFCN blockASIS, 281–282locating, nerve, 281

SSN block, 285Ultrasound-guided injections

atlanto-axial and atlanto-occipital joints, 353–356carpal tunnel, 308–311elbow, 319–321hip, 325–329knee, 331–334PNS (see Peripheral nerve stimulation)tendon dysfunction, 316–319trigger finger, 311–312wrist, 312–315

Ultrasound-guided interventional procedures (UGIP)didactic categories, training, 37errors, 37freehand technique, 62incorporation, Internet network, 57intervention, 42needle visualization, 43nerve stimulation, 71sound wave frequencies, 42ultrasound probe, 53

Ultrasound-guided regional anesthesiacolor Doppler

pain procedures, 29radial artery view, 30stationary transducer, 29

compound imaging, 32depth setting, 23–25focus

focal zone, 27level setting, 28optimize lateral resolution, 26

freeze button and image acquisition, 33frequency and probe selection, 22–23gain, 25–26optimization button, 32power Doppler, 30–31presets, 28time gain compensation, 26tissue harmonic imaging, 32

Ultrasound-guided regional anesthesia simulation phantom interactive tool (U-GRASP IT), 38, 41

Ultrasound guided shoulder jointacromio-clavicular

anatomy, 298–299clinical presentation, 299technique, 299

biceps tendon sheathanatomy, 297clinical presentation, 297technique, 297–298

glenohumeral joint (see Glenohumeral joint)injections, 294SC (see Sternoclavicular joint)soft tissue, 294subacromial/subdeltoid bursa

anatomy, 295clinical presentation, 295indications, 295limitations, 295technique, 295–296

subscapularis tendon and bursaanatomy, 303clinical presentation, 303technique, 303–304

superficial tendons, 294Ultrasound (US) imaging

3D and 4D2D transducers, 55matrix array transducer, 56needle, phantom, 56probes, 56static, 55

innovations, B-mode, 18principles, 14pulses, generation, 14tissue interaction

acoustic impedances, 16deeper structures, 15femoral neurovascular structures, 18friction-like losses, 17–18pulse encounters reflectors, 17sound transmission, 16–17

wavelength and frequencyattenuation, 15audible human hearing, 14body tissues and organs, 16refraction artifact, 17sound cycles, 14–15transducer, 15

Ultrasound in pain medicine (USPM), 280

372

Index

Umphrey, G.L., 313, 315Upper extremity, nerve blocks

axillaryanatomy and indication, 233probe placement, 234transducer, 234

brachial plexus anatomyposterior and medial cord, 229trunks, 228

distal peripheral nervesmedian and radial, 234, 235ulnar, 236

infraclavicularanatomy and indication, 232cords, 232probe placement, 233

interscaleneanatomy and indication, 229C6 vertebra, 229probe placement, 230unintentional epidural/spinal

anesthesia, 230peripheral techniques, 228supraclavicular

anatomy and indication, 230pneumothorax, 232probe placement, 231subclavian artery, 231

USPM. See Ultrasound in pain medicine

VVydyanathan, A., 179

WWeidner, N.J., 6Weinstabl, C., 9Wiley, C.W., 37, 44, 48, 65Wrist injections

anatomydescription, 319osteoarthritis, 319–320

ultrasound-guided techniquelong-axis approach, 314MR arthrography, 313rheumatoid arthritis (RA), 313short-axis dorsal approach, 315sonographic examination, 314trapeziometacarpal (TMC)/thumb CMC, 313

YYamamoto, H., 175Yamauchi, M., 175Yeo, S.T., 175Yoon, J.S., 181

ZZingas, CV., 316