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2018 Orthobiologics Surgical Skills Online
Hip Ultrasound Demo
Hip Ultrasound Demo
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Video Transcription
So, in a couple of the stations, some people started on the hip and they had trouble finding it to get started. And so, I always have the mantra, when I'm lost, is what do I know? And so, if I'm looking around for the hip and I'm not quite sure what's going on, well, I know where the femur is, right? So there's the femur. And so, I'm short axis on the femur. I'm just going to follow the femur up, keep following the femur up, keep following the femur up. Now I'm on the neck. Now I'm getting to the... And there we go. So, I'm on the hip joint. So, then I just turn long axis on the hip joint and I'm good to go. All right. So, again, if you're getting lost and think, what landmark do you know? And it's usually, not always, but usually going to be a bony landmark. And so, then what I like to do is optimize the long axis on the hip. So, if I'm rotating my probe, I'm not on that long axis of the cortex of the femur. Now I'm on the long axis of the cortex of the femur. I'm rotating it more and now I'm off. Okay. So, that's the image I'm looking for is to get a long axis as possible. And now I see the anterior capsule of the hip. And you can see where the anterior capsule inserts right above that arrow. All right. And then we can follow that. And now we see... We see the anterior acetabular labrum. If we go a little bit medial, we're on the iliopsoas tendon. All right. And then as we come back, we're on the joint itself. So, I'm going to optimize this image again. Look at the capsule. Now, if I was doing this injection on a live person, I'm going to put the Doppler on and I'm going to look for that lateral circumflex vessels. And I can see a couple little hypochoic dots right there that I think that they are. All right. So, I don't want to go through there. I want to actually end a little more. So, where Chris is pointing right there. Yep. So, that's, I guess. My guess is that's where they are. So, I tend to go a little more proximally, okay? And again, it's a distal. And so, we see my needle there. And so, typically, I'm going to follow my needle down and I'm just going to end right here. And sometimes, right at that curvature is pretty tight and it's hard to get the needle in and injectate in. And so, I'm going to back out and I'm actually going to go a little more superficial and come back in and aim a little higher. And now, I think I'm in a much better advantageous position. And so, what I would typically do is take a little bit of the local antiseptic, put it on the capsule, and then back out and then I would take my orthobiologic. I'm going to get right down and we'll just, oh, we had air in there. That's what we didn't want. But now, I'm inter-articular. I'm right on the articular cartilage of the femoral head. So, that's typically how I do my hip injections. So, let's take a few minutes and do that. And then, we'll go down to the knee. I didn't know whether you wanted to... Can you change moms to the...
Video Summary
In this video, the speaker discusses a technique for locating and injecting the hip joint. They explain that when they are unsure of the exact location of the hip, they use the femur as a reference point. By following the femur up and finding the neck, they are able to locate the hip joint. Once they find the hip joint, they adjust the probe to optimize the long axis of the hip. The speaker also mentions using Doppler to locate the lateral circumflex vessels and the importance of injecting in a specific area. They demonstrate the injection process and conclude by mentioning a transition to discussing knee injections. No specific credits were mentioned in the video.
Meta Tag
Author
tbd Hip
Date
October 13, 2018
Session
SAT_10-13-18_Hip_Ultrasound_Demo.mp4
Title
SAT_10-13-18_Hip_Ultrasound_Demo.mp4
Keywords
hip joint
locating technique
femur reference point
Doppler
injection process
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