2024 Workshop Handout Bundle-W74C Advanced Sonographic Needle Guidance for Carpal Tunnel Injection Shanina

W74C Advanced Sonographic Needle Guidance for Carpal Tunnel Injection Shanina

Pdf Summary

The document is a comprehensive guide on "Sonographic Needle Guidance for Carpal Tunnel Injections," authored by Dr. Elena Shanina. It is intended for the 2024 AANEM Annual Meeting. The main objectives of this guide are to explain the sonoanatomy of the carpal tunnel, discuss sonographic needle imaging approaches, compare ultrasound (US)-guided and blind method injections for treating carpal tunnel syndrome (CTS), highlight structural abnormalities that may affect the procedure, and demonstrate US-guided carpal tunnel injection techniques.<br /><br />CTS is a common neuropathy, and corticosteroid injections are an effective treatment. The risk of median nerve injury complicates blind injections, which have been used for decades. Ultrasound offers a clear advantage by enabling real-time visualization to guide injections, reduce injury risk, and improve outcomes.<br /><br />The document outlines the sonoanatomy of the carpal tunnel, emphasizing bony landmarks and the optimization of ultrasound transducer positioning for clear visualization of the median nerve and associated tendons. It discusses needle imaging approaches— in-plane and out-of-plane—and explains that in-plane is preferable for carpal tunnel injections.<br /><br />The document compares US-guided injections with the traditional blind method, noting that US-guided approaches show better efficacy and fewer complications, such as nerve injury or vascular complications, associated with blind methods. The equipment and materials required for US-guided injections are detailed, and a step-by-step technique is provided, emphasizing the significance of pre-procedure scanning to determine the safest needle approach.<br /><br />Also included are billing and coding information and documentation requirements for the procedures. This guide offers detailed insights into effectively and safely performing US-guided carpal tunnel injections. The document serves as background material for workshop sessions, with references to studies supporting the efficacy of sonographic needle guidance over the blind method for CTS treatments.

Keywords

Sonographic Needle Guidance

Carpal Tunnel Injections

Ultrasound-guided Injections

CTS Treatment

Sonoanatomy

Median Nerve

In-plane Needle Approach

Ultrasound Transducer Positioning

Corticosteroid Injections

AANEM Annual Meeting