2021 Workshop Handout Bundle-Sonographic Needle Guidance for Carpal Tunnel Injections

Sonographic Needle Guidance for Carpal Tunnel Injections - Shanina

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This document is a summary of a workshop presentation on sonographic needle guidance for carpal tunnel injections. The workshop was conducted by Dr. Elena Shanina, an associate professor of neurology at the University of Texas Medical Branch. The objectives of the workshop were to explain the sono-anatomy of the carpal tunnel and adjacent structures, discuss approaches for sonographic needle imaging, compare ultrasound-guided and "blind method" injections for carpal tunnel syndrome treatment, distinguish structural abnormalities and anatomical variations that may affect the procedure, and demonstrate the technique of ultrasound-guided carpal tunnel injection.<br /><br />The workshop highlighted the effectiveness of corticosteroid injections for carpal tunnel syndrome and the advantages of ultrasound-guided injections over blind injections. The real-time capabilities of ultrasound allow for continuous visualization of the needle during the procedure, precise positioning near the median nerve, and avoidance of neurovascular structure injuries. The workshop also provided information on the relevant sonoanatomy of the carpal tunnel, including bony landmarks, tendons, and the median nerve. Common anatomical variations and abnormalities that can affect the procedure were discussed as well.<br /><br />The workshop detailed the general principles of ultrasound-guided injections, including needle imaging techniques (in-plane and out-of-plane approaches), transverse versus longitudinal views, and ulnar versus radial approaches. It also discussed the indications and contraindications for carpal tunnel injections.<br /><br />The technique of ultrasound-guided carpal tunnel injection was described, along with the required equipment and materials. The procedure involves passing the needle into the skin on the ulnar side (or less commonly radial side), penetrating the transverse carpal ligament, and injecting the solution superficial to the median nerve. The spread of the injectate can be visualized under ultrasound, allowing for optimal positioning and circumferential spread around the nerve.<br /><br />Billing and coding information, documentation requirements, and references for further reading were also provided in the workshop.

Keywords

sonographic needle guidance

carpal tunnel injections

workshop presentation

Dr. Elena Shanina

associate professor

neurology

University of Texas Medical Branch

sono-anatomy

ultrasound-guided injections

blind injections