US guided ischial bursa injection

[nvrsumr]

Did one today. Have done a couple with fluoro before. Very cool. Definitely a role for US in interventional pain.

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[lobelsteve]

Did one today. Have done a couple with fluoro before. Very cool. Definitely a role for US in interventional pain.

Picture thread please...

I've got to get Narouze and a course.

 

[drf]

US has revolutionized bursas for me. Sure, I can do them blind or with fluoro, but it is very satisfying seeing the fluid, sticking a needle in there, and injecting a small volume.

I use US exclusively for SDSA, ischial, iliopsoas (not sure how one would do this without), trochanteric (I can separately evaluate trochanteric, subglut medius and subglut minimus bursas and place meds in one or all three depending on if I see fluid there), supra patellar, infra patellar.

Can't say I've had patients fail traditional approaches and have it work with US though as I have with other procedures.

 

[DOctorJay]

http://www.painmed.org/2012posters/abstract-134/

Got my decimal point wrong. It's 14 mm not 140.

Picture
http://www.painmed.org/2012posters/poster134.pdf

 

[DOctorJay]

come to AIUM this July. Rochester is beautiful in the summer!

 

[PMR2008]

http://www.painmed.org/2012posters/abstract-134/

Got my decimal point wrong. It's 14 mm not 140.

Picture
http://www.painmed.org/2012posters/poster134.pdf

👍 good stuff!!!

 

[drusso]

Nice! I've done them prone, but this makes more sense!

 

[PMR 4 MSK]

Not that it really needs to be said, but...

Make sure you are treating what you think you are treating for "bursitis". This past month I had a lady come in with 4 weeks of pain around the ischial tuberosity, hurt to sit on it, leaning sideways in chair. Injeciton to ischial tubersotiy bursa under US did not help very much. Got MRI - had complete hamstring tear. Sure did present like IT bursitis.

I've had plenty of greater trochanteric "bursitis" patients who were actually gluteal tears.

 

[drf]

Once you've seen the surrounding anatomy a few times and get comfortable with it you could get to the point where you can see tendinopathy and tears using the US.

 

[Dr. Ice]

Not that it really needs to be said, but...

Make sure you are treating what you think you are treating for "bursitis". This past month I had a lady come in with 4 weeks of pain around the ischial tuberosity, hurt to sit on it, leaning sideways in chair. Injeciton to ischial tubersotiy bursa under US did not help very much. Got MRI - had complete hamstring tear. Sure did present like IT bursitis.

I've had plenty of greater trochanteric "bursitis" patients who were actually gluteal tears.

So are you doing PRP on these people? Ive seen some patients with gluteual tears, but if what do you do for them?

 

[lonelobo]

come to AIUM this July. Rochester is beautiful in the summer!

And you can get a Garbage Plate!

 

[DOctorJay]

And you can get a Garbage Plate!

I have a feeling you're referring to Rochester, NY - AIUM is in Rochester, MN which was coincidentally named after the NY city.

 

[PMR 4 MSK]

So are you doing PRP on these people? Ive seen some patients with gluteual tears, but if what do you do for them?

Not me, but probably some people do. Meds, PT, cautious injection.

 

[Ducttape]

And you can get a Garbage Plate!

Have you ever had one?