Greetings to all subscribers, and a very happy Year of the Dragon in 2024! The dragon is the only mythical creature in the twelve zodiac signs and is considered a powerful symbol of good luck in Asian culture. May the dragon year bring you all great fortune and success in achieving your dreams.
As we continue, I'm excited to bring you into more detailed and clinically relevant discussions to refine your skills in diagnosis and treatment further. Basic ultrasound images and guidance for image-guided treatment will be shared with all subscribers. For those ready to tackle more complex issues, I will provide deeper insights appropriate to master and practical class members according to your advanced understanding, as these may be too intricate for general practice.
Today, we will focus on normal shoulder examinations, laying the groundwork for the more complex cases we will study together.
Due to its superficial location, the shoulder joint is highly amenable to ultrasound evaluation, making it one of the most frequently examined joints sonographically. Ultrasound examination of the rotator cuff is a common indication and is acknowledged as a precise method for assessing rotator cuff conditions. Like with other body parts, a meticulous physical examination, a thorough understanding of anatomy, correct scanning techniques, and knowledge of normal sonographic appearances are crucial for conducting an accurate and effective ultrasound assessment of the shoulder.
She experiences only mild shoulder pain; upon ultrasound examination, the features appear to be within normal limits.
For the initial scan, focus on the long head of the biceps tendon. The optimal position for examining the biceps tendon involves having the forearm supinated and resting on the thigh or slightly externally rotated arm. Begin by locating the long head of the biceps tendon situated between the greater and lesser tuberosities, using both transverse and longitudinal planes for a thorough examination. During the scan, assess the size of the biceps tendon and its fibrillar pattern, and look for any peritendinous fluid that may indicate pathology.
Begin by assessing the supraspinatus tendon along both its long and short axes. Use the intraarticular portion of the biceps tendon as a landmark to guide the proper orientation of the ultrasound transducer. The biceps tendon of the rotator interval separates the supraspinatous tendon anteriorly and borders the tendon's anterior margin.
Adjust the transducer by changing the direction until you can distinguish the biceps from the far anterior tendons. It is important because young individuals have minor tendon tears, which many doctors might overlook.
Sometimes, I move the humerus head to find the fine pathology of the supraspinatus and subacromial impingement with dynamic real-time images.
Lastly, To assess the infraspinatus and teres minor tendons, position the ultrasound transducer on the posterior aspect of the glenohumeral joint. In contrast, the patient places their hand on the opposite shoulder. Use the junction of the posterior edge of the acromion and the scapular spine as a landmark for the infraspinatus tendon. Clinically significant infraspinatus tendon tears are relatively uncommon unless there is an associated massive supraspinatus tendon tear. In some cases, internal impingement may occur, involving the posterior labrum and the internal corner of the posterior supraspinatus or infraspinatus tendon, which can cause pain during the wind-up or arm elevation positions.
#PracticalPainManagement #spinalintervention #imageguided #learning #koreauniversity #fellowshiptraining # ultrasoundguided #jointinjection#nerveblock #shoulder #safeinjection #asceptic #adhesivecapsulitis #spinalstenosis #rotatorcuff #foraminalstenosis #sacroiliacjoint #kneejoint #anklejoint#imagetrain #GE #Ziehm #MSK #chronicpain #case #lecture #cervical #lumbar #knee #elbow #noninvasive #painfree #ISURA #paindiploma #madi #precise #decisionmaking #limethasone #dexamethasone #palmitate
#이미지트레이닝 #만성통증 #통증 #초음파시술 #초음파 #시술 #안전한시술
26 авг 2024
