Diagnostic ultrasound ( PDFDrive )

CHAPTER 25 Musculoskeletal Interventions 911
A
B
C
FIG. 25.23 Ultrasound-Guided Paralabral Cyst
Aspiration in the Spinoglenoid Notch of the Shoulder.
Spinoglenoid Notch Cyst Aspiration. (A) Axial fatsuppressed
proton-density image that has been inverted
for purposes of comparison with ultrasound. The cyst
(C) is depicted appearing as a homogeneously T2-bright
structure. The cyst produces bony remodeling of the
adjacent glenoid. (B) Anechoic cyst (C) remodeling the
spinoglenoid notch (sgn). The humeral head (hh) is labeled.
(C) A 20-gauge spinal needle (arrow) is positioned within
the cyst. See also Video 25.3.
Right shoulder
Right shoulder
D
N
T
H
A
B
FIG. 25.24 Ultrasound-Guided Aspiration and Injection for Calciic Tendinosis. (A) Image shows 20-gauge spinal needle (N) positioned
into the calciication (arrow) under ultrasound guidance in 42-year-old man with shoulder pain. D, Deltoid; H, humeral head. (B) Series of repeat
lavage and aspirations of the calciication are performed, with the calciication eventually largely replaced by luid contents within the surrounding
pseudocapsule of the calciic mass. T, Rotator cuff tendons. Note that the degree of posterior acoustic shadowing has diminished and that the
center of the calciication (arrow on A) is partially replaced by luid. After numerous lavages, the calciication is typically fenestrated, and a therapeutic
mixture is injected and often decompresses into the subdeltoid bursa (not shown).