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Hand and Wrist Injections: Ultrasound 

Hand and Wrist Injections: Ultrasound
Chapter:
Hand and Wrist Injections: Ultrasound
Source:
Multimodality Imaging Guidance in Interventional Pain Management
Author(s):

Marko Bodor

, Sean Colio

, and Christopher Bonzon

DOI:
10.1093/med/9780199908004.003.0045

Two basic ultrasound-guided approaches are used for procedures to diagnose and treat chronic pain in the upper extremity. The short-axis approach is best for injections of superficial, vertically oriented joints, whereas the long-axis approach is best for relatively deep injections and more open joints or whenever it is necessary for the needle to be seen at all times. Ultrasound can guide injections for nerve compressions. Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. Ulnar tunnel syndrome occurs in the setting of space-occupying lesions. Ultrasonography can identify a space-occupying lesion, while electrodiagnostic studies can help differentiate ulnar neuropathy at the wrist from ulnar neuropathy at the elbow. Ultrasound can also guide injections at joints such as the basilar join of the thumb, phalangeal joints, and wrist joints. Ultrasound-guided injections are also useful for tendon dysfunctions including de Quervain’s Tenosynovitis, trigger finger, intersection syndrome, and tendon impingement.

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