Ultrasound Guided Glenohumeral Injection..short axis to the needle

Ultrasound Guided Glenohumeral Injection..short axis to the needle..by probeultrasound.com
-Scott Weiss, MD

[@kerithj6919]

That was very good! Thank you for sharing. What type of medicine do you practice? I'm an ER doc and have been using the in plane approach but never considered an out of plane approach until I recently came across another physician who released a video using the same approach as yours. I have used a curvilinear probe because it is often easier to visualize the needle especially in larger patients. What size needle do you use and what is in the injectate?

[@scottweiss3100]

Hi Kerith...sorry for the delayed response, I practice non-surgical sports medicine...for this out of plane approach I use a 1.5 inch needle, 22 gauge...its a direct approach into the joint which I like...but really need to go slow and use a jiggle technique to get a good sense where you are...currently I don't use this approach...I prefer in plane approach with the patient in a lateral decubitus position with infraspinatus in long axis and slipping the needle under the infraspinatus into the joint...going just medial to the footprint of the tendon on the middle facet of the greater tuberosity...this way I'm in the joint but far from the labrum/glenoid...to avoid nicking them with the needle. Thanks! Scott Weiss, MD

[@alinethomaz9433]

@@scottweiss3100 I am an anesthesiology-trained interventional pain fellow, thank you for the video. What is the jet/spray you used in this video to anesthetize the skin prior to insertion of your needle?

[@felixadrian5355]

What needle are you using?

[@scottweiss3100]

Hi..sorry for the delayed response...for a out of plane shoulder injection you can usually use a 1.5 inch 22 gauge or thinner needle. -Scott