Journal of Ultrasound in Medicine, Vol 20, Issue 1 21-26, Copyright © 2001 by American Institute of Ultrasound in Medicine
Use of ultrasonographic guidance in interventional musculoskeletal procedures: a review from a single institution
C. M. Sofka, A. J. Collins and R. S. Adler
Department of Radiology and Nuclear Medicine, The Hospital for Special Surgery, New York, New York 10021-4828, USA.
We have evaluated the utility of ultrasonographic guidance for intervention
in the musculoskeletal system. All interventional musculoskeletal
procedures using ultrasonographic guidance performed at our institution
from July 1998 through November 1999 were reviewed. Examinations were
performed using either a linear or curved phased array transducer, based on
depth and local geometry. The choice of needle was likewise optimized for
specific anatomic conditions. One hundred ninety-five procedures were
performed on 167 patients from July 1998 through November 1999. Thirty-one
procedures had magnetic resonance correlation within 6 months beforehand.
Excluding large-joint aspirations and injections, we found that 180 of the
procedures were more readily performed using ultrasonography than any other
imaging modality. These included therapeutic injections into tendon sheaths
(biceps, flexor digitorum longus, posterior tibial, and iliopsoas),
Morton's neuromas, plantar fascia, wrist ganglia, and tarsal tunnel cysts;
peritendinous hamstring injections; and synovial cyst and muscle biopsies.
In all cases, the target of interest was identified easily with
ultrasonography, and needle position was documented readily. Also in all
cases, aspiration or medication delivery to the site of interest was
observed during real time and was documented on postprocedure images of the
area. No significant complications (e.g., bleeding, infection, and
neurovascular compromise) were encountered during or immediately after any
procedure. Ultrasonography is a readily available imaging modality useful
for guiding interventional procedures in the musculoskeletal system. The
ability to document exact needle placement in real time confirms accurate
placement of therapeutic injections, fluid aspiration, and soft tissue
biopsies.
