ARRS 2022 Abstracts

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E1642. A Real Shot in the Arm: Review of Anatomy, Equipment, and Technique for Ultrasound-Guided Injections of the Upper Extremity
Authors
  1. Mohamad Hadied; Henry Ford Hospital
  2. Mariam Salman; Henry Ford Hospital
  3. Perra Razoky ; Wayne State University School of Medicine
  4. Magliel Romero-Marquez; Henry Ford Hospital
  5. Steven Soliman; Henry Ford Hospital
  6. Chad Klochko; Henry Ford Hospital
Background
Routine outpatient steroid injections are becoming common as a bridging therapy to definitive treatment or used as periodic treatment for those with ongoing joint pain due to a variety of joint pathologies. This exhibit aims to review safe ultrasound-guided techniques for steroid injections of the upper extremity.

Educational Goals / Teaching Points
This exhibit provides an overview of normal sonographic anatomy, patient position, and localization for outpatient steroid injection of the posterior shoulder, sub-acromial space, acromioclavicular joint, biceps tendon sheath, posterior elbow, and carpal tunnel. The exhibit will also serve as a review of the procedure indications and material needed for steroid injection, aspiration, and calcium breakups.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A pictorial and dynamic ultrasound review of sonographic anatomy and needle approach and positioning will be demonstrated for steroid injections of the posterior glenohumeral joint, sub-acromial space, acromioclavicular joint, biceps tendon sheath, posterior elbow, and carpal tunnel. A pictorial and dynamic ultrasound guide of calcific tendinosis in the shoulder with calcium break-up technique including anatomy, needle position, and pathophysiology of calcium formation/reabsorption will also be reviewed.

Conclusion
Steroid injections are commonly performed in the setting of upper extremity joint pain. Ultrasound is an easily accessible and portable imaging modality that does not expose the patient to radiation or contrast. Ultrasound guidance for steroid injections of the upper extremity allows for direct visualization of the needle, surrounding soft tissues, and neurovascular structures.