Middle of screen marker12/11/2022 US equipment is also more portable and less expensive. The ability to visualize the targeted structure and other structures of importance, such as blood vessels, lung, or other organs, should, logically, also improve the speed and safety of the procedures.Ĭompared to the use of fluoroscopy-guided procedures that can only visualize bony tissue, US additionally allows the visualization of soft tissues. The advantages of US guidance include the ability to both view the targeted structure and visualize, in real time, the distribution of the medication throughout and relative to the tissue (e.g., nerve tissue), as well as the capacity to control its distribution by readjusting the needle position, capabilities which should plausibly improve the success rate of the procedures. These assumptions, of course, are not entirely correct, and could potentially be responsible for block failure or block placement difficulties when these conventional techniques are used. US guidance for nerve blocks and interventional pain management techniques may have several potential advantages over conventional landmark-based techniques that assume minimal anatomical variation between persons, or nerve stimulation-assisted techniques that are based on the premise that an appropriate motor response is the perfect surrogate marker for needle proximity to the sensory fibers of a nerve. Ultrasound (US) use has rapidly entered the field of acute pain medicine and regional anesthesia and interventional pain medicine over the last decade, and it may even become the standard of practice. We only briefly touch on topics dealing with physics, artifacts, or sonopathology, which are available elsewhere in the medical literature. At the end, we discuss US-guided needle advancement. We discuss the sonographic appearance of different tissues, introduce the reader to commonly used US-related terminology, cover basic machine “knobology” and fundamentals of US probe selection and manipulation. MIDDLE OF SCREEN MARKER SKINWe stress that for the best use of US, one should venture beyond the “pattern recognition” mode to the more advanced systematic approach and use US as a tool to visualize structures beyond the skin (sonoanatomy mode). This article provides basic information on musculoskeletal US techniques, with an emphasis on the principles and practical aspects. US guidance should plausibly improve the success rate of the procedures, their safety and speed. The advantages of US guidance over conventional techniques include the ability to both view the targeted structure and visualize, in real time, the distribution of the injected medication, and the capacity to control its distribution by readjusting the needle position, if needed.
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