Diagnostic ultrasound ( PDFDrive )

T
T
N
A
B
C
FIG. 25.8 Retrocalcaneal Bursa Injection. (A)
Short-axis view shows Achilles tendon (T) in 59-year-old
man with retrocalcaneal pain and history of Haglund
deformity. A 25-gauge needle (N) enters perpendicular
to the tendon’s long axis and terminates in a small,
retrocalcaneal bursal effusion. (B) Rotating transducer
90 degrees results in the more typical short-axis view,
with the needle (arrow) seen in cross section. (C)
Under observation in real time, the bursa distends
(arrows) and ills with echogenic material (contrast
effect). The needle is still evident within the distended
bursa.
PRE-INJECTION
POST-INJECTION
N
T
A
B
FIG. 25.9 Tendon Sheath Injection Using Short-Axis Approach. A 17-year-old female patient with medial ankle pain was referred for
ultrasound-guided injection of posterior tibial tendon sheath. (A) Preinjection view shows 25-gauge needle (N) within a small tendon sheath effusion
(long arrow) in the inframalleolar portion of the tendon (T). The tendon, which is inhomogeneous, is seen in cross section. (B) Postinjection view
shows that the tendon sheath is distended, conirming appropriate deposition of the injected material. Note that the tendon margins are better
delineated because of a tenosonographic effect of the injected luid. The vascular pedicle (short arrow) of the tendon is evident.
PRE-INJECTION
POST-INJECTION
TA
T
N
A
B
FIG. 25.10 Flexor Hallucis Longus (FHL) Tendon Sheath Injection. Short-axis approach with ultrasound guidance in 31-year-old professional
dancer with posteromedial ankle pain during plantar lexion. (A) Preinjection image depicts the tendon (T) at the level of the posterior sulcus of
the talus (TA). The arrows show relationship of the tendon to the neurovascular structures. (B) Postinjection image depicts 25-gauge needle (N)
situated within the distended tendon sheath (arrows) below the neurovascular structures.