Sonographically guided obturator internus injections: Techniques and validation

Jay Smith, Steve J. Wisniewski, Michael K. Wempe, Bradford W. Landry, Jacob L. Sellon

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives-The primary purpose of this investigation was to describe and validate sonographically guided techniques for injecting the obturator internus (OI) muscle or bursa using a cadaveric model. Methods-A single experienced operator completed 10 sonographically guided OI injections in 5 unembalmed cadaveric pelvis specimens (4 female and 1 male, ages 71- 89 years with body mass indices of 15.5-24.2 kg/m 2). Four different techniques were used: (1) OI tendon sheath (4 injections), (2) OI intramuscular (2 injections), (3) OI bursa trans-tendinous (2 injections), and (4) OI bursa short-axis (2 injections). In each case, the operator injected 1.5 mL of diluted yellow latex using direct sonographic guidance and a 22-gauge, 87.5-mm (3 1/2-in) needle. Seventy-two hours later, study coinvestigators dissected each specimen to assess injectate placement. Results-All 10 OI region injections accurately placed latex into the primary target site. Two of the 4 OI tendon sheath injections produced overflow into the underlying OI bursa. Both OI intramuscular injections delivered 100% of the latex within the OI. All 4 OI bursa injections (2 trans-tendinous and 2 short-axis) delivered 100% of the latex into the OI bursa, with the exception that 1 OI bursa trans-tendinous injection produced minimal overflow into the OI itself. No injection resulted in injury to the sciatic nerve or gluteal arteries, and no injectate overflow occurred outside the confines of the OI or its bursa. Conclusions-Theresults of this investigation demonstrate that sonographically guided injections into the OI or its bursa are feasible and, therefore, may play a role in the diagnosis and management of patients presenting with gluteal and "retrotrochanteric" pain syndromes.

Original languageEnglish (US)
Pages (from-to)1597-1608
Number of pages12
JournalJournal of Ultrasound in Medicine
Volume31
Issue number10
StatePublished - Oct 1 2012

Fingerprint

Injections
Latex
Intramuscular Injections
Tendons
Sciatic Nerve
Pelvis
Needles
Body Mass Index
Arteries
Pain
Muscles
Wounds and Injuries

Keywords

  • Gluteal
  • Hip
  • Obturator internus injection
  • Sonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Medicine(all)

Cite this

Smith, J., Wisniewski, S. J., Wempe, M. K., Landry, B. W., & Sellon, J. L. (2012). Sonographically guided obturator internus injections: Techniques and validation. Journal of Ultrasound in Medicine, 31(10), 1597-1608.

Sonographically guided obturator internus injections : Techniques and validation. / Smith, Jay; Wisniewski, Steve J.; Wempe, Michael K.; Landry, Bradford W.; Sellon, Jacob L.

In: Journal of Ultrasound in Medicine, Vol. 31, No. 10, 01.10.2012, p. 1597-1608.

Research output: Contribution to journalArticle

Smith, J, Wisniewski, SJ, Wempe, MK, Landry, BW & Sellon, JL 2012, 'Sonographically guided obturator internus injections: Techniques and validation', Journal of Ultrasound in Medicine, vol. 31, no. 10, pp. 1597-1608.
Smith J, Wisniewski SJ, Wempe MK, Landry BW, Sellon JL. Sonographically guided obturator internus injections: Techniques and validation. Journal of Ultrasound in Medicine. 2012 Oct 1;31(10):1597-1608.
Smith, Jay ; Wisniewski, Steve J. ; Wempe, Michael K. ; Landry, Bradford W. ; Sellon, Jacob L. / Sonographically guided obturator internus injections : Techniques and validation. In: Journal of Ultrasound in Medicine. 2012 ; Vol. 31, No. 10. pp. 1597-1608.
@article{3d4133435a4246a3b3e8ba9b1b761e0b,
title = "Sonographically guided obturator internus injections: Techniques and validation",
abstract = "Objectives-The primary purpose of this investigation was to describe and validate sonographically guided techniques for injecting the obturator internus (OI) muscle or bursa using a cadaveric model. Methods-A single experienced operator completed 10 sonographically guided OI injections in 5 unembalmed cadaveric pelvis specimens (4 female and 1 male, ages 71- 89 years with body mass indices of 15.5-24.2 kg/m 2). Four different techniques were used: (1) OI tendon sheath (4 injections), (2) OI intramuscular (2 injections), (3) OI bursa trans-tendinous (2 injections), and (4) OI bursa short-axis (2 injections). In each case, the operator injected 1.5 mL of diluted yellow latex using direct sonographic guidance and a 22-gauge, 87.5-mm (3 1/2-in) needle. Seventy-two hours later, study coinvestigators dissected each specimen to assess injectate placement. Results-All 10 OI region injections accurately placed latex into the primary target site. Two of the 4 OI tendon sheath injections produced overflow into the underlying OI bursa. Both OI intramuscular injections delivered 100{\%} of the latex within the OI. All 4 OI bursa injections (2 trans-tendinous and 2 short-axis) delivered 100{\%} of the latex into the OI bursa, with the exception that 1 OI bursa trans-tendinous injection produced minimal overflow into the OI itself. No injection resulted in injury to the sciatic nerve or gluteal arteries, and no injectate overflow occurred outside the confines of the OI or its bursa. Conclusions-Theresults of this investigation demonstrate that sonographically guided injections into the OI or its bursa are feasible and, therefore, may play a role in the diagnosis and management of patients presenting with gluteal and {"}retrotrochanteric{"} pain syndromes.",
keywords = "Gluteal, Hip, Obturator internus injection, Sonography",
author = "Jay Smith and Wisniewski, {Steve J.} and Wempe, {Michael K.} and Landry, {Bradford W.} and Sellon, {Jacob L.}",
year = "2012",
month = "10",
day = "1",
language = "English (US)",
volume = "31",
pages = "1597--1608",
journal = "Journal of Ultrasound in Medicine",
issn = "0278-4297",
publisher = "American Institute of Ultrasound in Medicine",
number = "10",

}

TY - JOUR

T1 - Sonographically guided obturator internus injections

T2 - Techniques and validation

AU - Smith, Jay

AU - Wisniewski, Steve J.

AU - Wempe, Michael K.

AU - Landry, Bradford W.

AU - Sellon, Jacob L.

PY - 2012/10/1

Y1 - 2012/10/1

N2 - Objectives-The primary purpose of this investigation was to describe and validate sonographically guided techniques for injecting the obturator internus (OI) muscle or bursa using a cadaveric model. Methods-A single experienced operator completed 10 sonographically guided OI injections in 5 unembalmed cadaveric pelvis specimens (4 female and 1 male, ages 71- 89 years with body mass indices of 15.5-24.2 kg/m 2). Four different techniques were used: (1) OI tendon sheath (4 injections), (2) OI intramuscular (2 injections), (3) OI bursa trans-tendinous (2 injections), and (4) OI bursa short-axis (2 injections). In each case, the operator injected 1.5 mL of diluted yellow latex using direct sonographic guidance and a 22-gauge, 87.5-mm (3 1/2-in) needle. Seventy-two hours later, study coinvestigators dissected each specimen to assess injectate placement. Results-All 10 OI region injections accurately placed latex into the primary target site. Two of the 4 OI tendon sheath injections produced overflow into the underlying OI bursa. Both OI intramuscular injections delivered 100% of the latex within the OI. All 4 OI bursa injections (2 trans-tendinous and 2 short-axis) delivered 100% of the latex into the OI bursa, with the exception that 1 OI bursa trans-tendinous injection produced minimal overflow into the OI itself. No injection resulted in injury to the sciatic nerve or gluteal arteries, and no injectate overflow occurred outside the confines of the OI or its bursa. Conclusions-Theresults of this investigation demonstrate that sonographically guided injections into the OI or its bursa are feasible and, therefore, may play a role in the diagnosis and management of patients presenting with gluteal and "retrotrochanteric" pain syndromes.

AB - Objectives-The primary purpose of this investigation was to describe and validate sonographically guided techniques for injecting the obturator internus (OI) muscle or bursa using a cadaveric model. Methods-A single experienced operator completed 10 sonographically guided OI injections in 5 unembalmed cadaveric pelvis specimens (4 female and 1 male, ages 71- 89 years with body mass indices of 15.5-24.2 kg/m 2). Four different techniques were used: (1) OI tendon sheath (4 injections), (2) OI intramuscular (2 injections), (3) OI bursa trans-tendinous (2 injections), and (4) OI bursa short-axis (2 injections). In each case, the operator injected 1.5 mL of diluted yellow latex using direct sonographic guidance and a 22-gauge, 87.5-mm (3 1/2-in) needle. Seventy-two hours later, study coinvestigators dissected each specimen to assess injectate placement. Results-All 10 OI region injections accurately placed latex into the primary target site. Two of the 4 OI tendon sheath injections produced overflow into the underlying OI bursa. Both OI intramuscular injections delivered 100% of the latex within the OI. All 4 OI bursa injections (2 trans-tendinous and 2 short-axis) delivered 100% of the latex into the OI bursa, with the exception that 1 OI bursa trans-tendinous injection produced minimal overflow into the OI itself. No injection resulted in injury to the sciatic nerve or gluteal arteries, and no injectate overflow occurred outside the confines of the OI or its bursa. Conclusions-Theresults of this investigation demonstrate that sonographically guided injections into the OI or its bursa are feasible and, therefore, may play a role in the diagnosis and management of patients presenting with gluteal and "retrotrochanteric" pain syndromes.

KW - Gluteal

KW - Hip

KW - Obturator internus injection

KW - Sonography

UR - http://www.scopus.com/inward/record.url?scp=84867226819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867226819&partnerID=8YFLogxK

M3 - Article

C2 - 23011623

AN - SCOPUS:84867226819

VL - 31

SP - 1597

EP - 1608

JO - Journal of Ultrasound in Medicine

JF - Journal of Ultrasound in Medicine

SN - 0278-4297

IS - 10

ER -