Diagnostic ultrasound ( PDFDrive )

908 PART III Small Parts, Carotid Artery, and Peripheral Vessel Sonography
A
B
FIG. 25.18 Ultrasound-Guided Hamstring Peritendinous Injection. A 50-year-old female runner with left buttock pain. (A) Axial fat-suppressed
T2-weighted sequence positioned in a manner similar to that viewed by a sonographer. The hamstring origin (T) and ischium (I) are labeled. The
sciatic nerve (arrow) appears as a mildly hyperintense ellipse lateral to the ischium and supericial to the quadratus femoris. F, Femur. (B) A 22-gauge
spinal needle (N) is positioned in short axis, using a lateral approach, adjacent to the margin of the hamstring tendon origin (T). The sciatic nerve
(arrow) and ischium (I) are labeled.
N
nv
A
fh
e
B
FIG. 25.19 Ultrasound-Guided Aspiration and Injection of Multiloculated Iliopsoas Bursa. (A) Image shows 22-gauge spinal needle (N)
positioned into the lateral component of the bursa in a 65-year-old woman with groin pain. e, Iliopectineal eminence; fh, femoral head. (B) After
aspiration of the lateral component, the needle has been advanced into the medial component for aspiration and subsequent injection with therapeutic
mixture. nv, Neurovascular structures.
PRE-INJECTION
POST-INJECTION
N
C
mhg
A
B
FIG. 25.20 Ultrasound-Guided Aspiration and Injection of Clinically Suspected Baker Cyst. (A) Preinjection image shows 22-gauge needle
(N) positioned in the cyst (C) under ultrasound guidance in 59-year-old woman with posterior knee pain and swelling. mhg, Medial head of gastrocnemius
muscle. (B) After cyst aspiration and injection of the therapeutic mixture, the anechoic luid is replaced by echogenic luid resulting from contrast
effect (arrows).