INNOVATIVE IMAGING TECHNIQUES TO ENHANCE THE QUALITY OF YOUR PRACTICE
Fig. 3. The ultrasound is placed caudal to the shoulder with the screen facing cranially. The ultrasonographer is standing just cranial and lateral to the shoulder. This minimizes awkward body positioning during the procedure.
The ultrasound machine is prepared by placing a
sterile glove filled with coupling gel over the trans- ducer, adjusting the ultrasound image to 6 cm of depth, and, if a variable mHz probe is used, setting the frequency of ultrasound transducer to approxi- mately 5 to 10 mHz. Patient preparation consists
of a sterile surgical preparation of the shoulder re- gion. Local anesthetic (subdermal injection at the injection site) may be used to desensitize the skin; however, needle placement is generally well-toler- ated. Ideally, the ultrasound machine is positioned behind the plane of the shoulder, with the screen
Fig. 4. The image on the left is a parasagittal ultrasound image of the shoulder (proximal is to the top of the image) with the corresponding lateral aspect of a skeletal specimen (right image). 1, Scapula, 2, humerus. The arrows are highlighting the joint space of the scapulohumeral joint. The arrowheads are highlighting the cranial part of the greater tubercle.
