Patient Positioning
Patient seated on a revolving stool. Position one: The palmar side of the hand on the superior aspect of the iliac wing, elbow posterior. Position two: The dorsum of the hand over the opposite back pocket, which leads to an internal rotation. The supraspinatus is directed more anteriorly.
Probe Positioning
The intraarticular portion of the long head of biceps is found easily medial – rotate the probe to get its long axis. The long head of biceps and the supraspinatus tendon run in parallel. Then shift the transducer a little cranially and posteriorly over the supraspinatus tendon – this is the long axis view of the tendon were the bursa easily can be injected.
note: ultrasound guided infiltration of the subacromial subdeltoid bursa in a patient with chronic bursitis due to CPPD
note: ultrasound guided infiltration of the subacromial subdeltoid bursa in a patient with bursitis
note: during the injection of the subdeloide bursa, the tear of the tendon becomes visible (discontinuation of the tendon)
note: partial tears are sometimes better visible during injection of the bursa, when the injected agent seperates the surronding soft tissue.