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very helpful. thank you. I've been on my MSK ultrasound era for a couple years now and the hand and fingers are the trickiest.

at 3:10 probe marker is oriented on the left side of patient?many thanks for sharing

Thanks. Helpful

What are the treatment options for dorsal scapular nerve entrapment?

Thank you very much!

Can you tell me if this is considered a painful procedure?

Is PRP effective in RCL rupture?

Very useful and detailed. Still get a lot even as a CIPS doctor. Thank you ~~

the question is, how painful is this?? I am in America and was just diagnosed with Dorsal scapular nerve entrapment.

Who gives these shots? Like doctor wise?

Hi doc, may I ask if I can request an ultrasound to a doctor? Thank you

Many thanks for the nice demonstration. Your limb position is probably the best for ulnar nerve sonography at elbow.

Did Kate infact have popliteal entrapment?

Best video online regarding the Deltoid ligament in terms of ultrasound assessment

🌹0:58 前彎 、水平內收、水平外展 測試穩定度

🌹1:52 Subtalar Jt

Great, thank you! it is harder for me to scan the anterior section of the deltoid, especially the tibio-spring ligament so need to practice a bit more. Find it is easier to scan the posterior and middle parts. Thank you again for your videos - find them super helpful!

Outstanding lecture ❤

great task

❤good teaching 🎉

Good teaching ❤

Good teaching ❤

Thank you so much for this amazing explanation and demonstration. You are doing an excellent job with your channel- much appreciated! By far the most informative lecture of the rotator interval I’ve seen so far. Best regards from Germany

What ultrasound system you guys use ? And what you think which one is best optimal in msk?

I'm sure there is a lot of very useful information presented here but spoken way too fast looking away from the audience made more difficult by the accent. Maybe a little text block or transcript would be helpful.

Which doctor should i see for this condition?

Good job

Lovely demo! You do mean pronate for cobra view though hey?

I noticed that you are a sonographer/physio - can physio's do USGI in australia? many thanks (from UK)

👌 🌹1:34 🌹2:01 下方關節囊

👌🌹1:00 1:31 🌹1:43 2:21 Rotator Interval 🌹1:48 2:30 喙肱韌帶 1:50 上肱盂韌帶 🌹3:51 肱二頭腱注射

Hi chaps - can I confirm that physios in australia are able to scan, inject and prescribe? many thanks

Very Nice Video

Great

Fantastic. Thank you

Really good interview !!

thank you! very helpful!

Thank you so much. Simple and efficient explanation. Keep your videos coming.

Thank you 👍🏻

Much appreciated Sir!

Thanks for the scanning , it would be fantastic if you could do a routine ankle scan & the series you normally take, it would be even better if the patient had lots of pathology so you could talk about what you are seeing, many thanks

👌👍👍👍One of the best I have ever watched! Excellent!!!👍 🌹1:05 左肩:頂觀(左) 後觀(右) 🌹1:40 重要示意圖:注意[關節囊]組織:肩胛下腱、喙肱韌帶、棘上腱、棘下腱在圖示可知皆[ 貼融在關節囊表層] 、在各腱近著骨位置時已與囊的外層[ 融於一體]。唯肱二長腱是[關節囊內]自由滑動結構, 且與關節囊內層並未有融為一體的事實。圖中, 在關節腔部份的肱二長腱短軸切面可知:肱二腱的表面是先有一層關節囊, 在關節囊的上一層才是喙肱韌帶, 只不過在肩袖間隙視窗位置時,這層關節囊和喙肱韌帶雖有組織學的層次之分但實際已融為一體。 🌹2:53 肱二腱及其近心端的biceps-labrial complex肱二腱盂唇複合體 3:58 絕大多數肱二腱旁有積液其實 是#肩關節腔內積液, 代表#肩GH關節腔內有病灶且有發炎積水。 🌹7:31 Biceps pully (左)左肩(前外觀)SCT是什麼? MCHL的M 指(middle) CHL應是喙肱韌帶。 (右) 右肩外觀 上肱盂韌帶SGHL(在肱二長腱前內下方)和中段喙肱韌帶MCHL (在肱二長腱上方):皆具有在肩袖間隙處穩定肱二腱的功能。 🌹7:57 肩袖間隙(定格) RCI :Rotator Cuff Interval 或 RI:Rotator Interval 左圖顯示若針尖置於[#肩袖間隙視窗]所掃瞄的、[#已是關節囊內]、界於#肱二腱上層(短軸)、且在#喙肱韌帶(較淺)、關節囊(較深) (但#肩袖間隙視窗位置的喙肱韌帶和關節囊已融合一體、此所謂較深較淺只是就組織學而言) 的下層 之間的#間隙處, 乃屬#關節囊內(腔內)注射, 對早期正在發炎階段的五十肩是有意義的。不過不能注射在肱二腱本體就是啦! 但是, 對早期五十肩#更重要注射LIS處則是 💜#喙肱韌帶的喙突端 的SubCoracoid Triangle內的中內段喙肱韌帶!! 🌹8:50 #喙肱韌帶(定格) 🌹9:20 9:25 (皆定格) 超聲圖左為喙突 右為肱骨端。喙突肩峰韌帶(此畫面已非RCI肩袖間隙位置的視窗而是於肩袖間隙位置#的更向內、較貼近喙突端。 喙突端的[喙突肩峰]韌帶著骨於喙突[外側後緣區較表層, 而其全長中的一段的較深處有[喙肱韌帶]交叉行經，彼此[略近於]直角相交。 #喙突肩峰韌帶 的走行由(前、略下略內的)(喙突外側後緣表層) 往(後略上、略外)的肩峰前緣 。 #喙肱韌帶 的走行則由(內、略後、略上)喙突#內側後緣底層 向(外、略前、略下)跨越肱骨頭前上方關節囊(在此已接近並融一起)及其下層的軟骨, 附著於肱骨大小節結近端且在RCI域把肱二長腱自內、頂、外側包覆著。喙-肩峰韌帶(較淺) 與#喙肱韌帶(較深) 在RCI處雖是上下層關係但[走向近乎交叉僅有小部份重疊] 走向彼此既非平行也非垂直! 。 🌹9:26 9:27 (皆定格) 箭頭恰指在#喙肱韌帶(一條完整帶狀低回音, 左方為喙突端 右方為肱骨端) 要觀察#喙肱韌帶 鬆緊、是否短縮=>記得應做肱骨頭的內/外轉(而非外展)來參考判斷。 🌹9:34 上肱盂韌帶 🔯註:五十肩的#喙肱韌帶類固醇少量Blind注射: A. 喙突外側緣中點 B. 肩峰外緣前端 在#AB連線上#距A約1cm處下層即有 #喙肱韌帶經過, 可垂直於該點進針為。 10:30 (定格)在RCI視窗中的肱二腱在RCI的前內側端(小轉子)總是斜著”側倒壓向” #上肱盂韌帶(在肱二腱的前下方還有一層關節囊組織阻隔著肱二腱和上肱盂韌帶，此描述參見Canon C. Martiloni -Ultrasound dissection of rotator cuff @ 25: 28,而與本影片7:57意示圖有出入，在本片7:57的圖中短軸肱二腱和上盂肱韌帶間未畫出關節囊這一層且上盂肱韌帶與肱二腱是一起被喙肱韌帶在表面包覆著 ) 11:25 肱二頭肌病變 🔯12:34 💜五十肩 常見#喙肱韌帶發炎、腫脹、變厚、變短、變緊, 而限制了肩關節的[外轉] [後伸]。 13:02 (定格) 13:34 (定格) 17:32 (定格) 肩胛下肌 =================== 🔯🔯20:02 (定格) #肱二頭肌與腱及肩袖間隙掃描:[文字大綱]和[示範] 肱骨擺在Neutral姿, 掌朝上置大腿上。觸診出肱二肌溝, 探頭從肱二肌溝的肱二長腱開始掃描。 21:06 21:13 注意, 在此, 探頭開始要配合肱骨頭弧度變化而略傾轉roll(探頭器尾部拉往站在背後的檢查者)並往身體內側滑, 以追尋開始在肱骨頭前上方轉折向內走行#在RCI位置的 21:27 22:04 肱二頭長腱(短軸) 影像。(注意影片右下人體所示探頭擺位方向) 21:50有時至此, 可改將上臂向後伸略調整成modified Crass擺位, 以獲更佳影像。 💜👍22:08~22:11#上肱盂韌帶 💜👍 22:06(定格)#外喙肱韌帶(近棘上腱端) ~22:08#內喙肱韌帶(近肩胛下腱端) 22:12~22:28 (定格) 喙肱韌帶(箭頭)覆在肱二長腱表層(俱為兩者短軸切面)後, (向畫面左側，就解剖而言是向外側的SS腱短軸)再分深淺兩層, 自棘上腱短軸的表層和底層做包覆棘上腱。 22:23 (定格) 在RCI視窗中喙肱韌帶覆在小節結位置肩胛下腱表層。 22:59 在偏頭端的肩胛下腱的小節結附著處尋是否骨表面不平整之著骨病徵。 23:12 將肱骨做外轉使肩胛下肌/腱看得更完整 🏵️23:34 在1.#RCI和 2.肱二溝的注射! 1. 🌹#在RCI位置:如五十肩時, 於喙肱韌帶的喙突端即#喙突內側、#後緣、#下緣[本片無示範:注液3cc (steroid: dexamethasone 1cc+50%G/W 1.5cc)] ;掃瞄RCI肱二長腱短軸呈現時,界於二頭腱上層、喙肱韌帶下層潛在空隙16:27 (此處不僅是腱旁注射, 也是一種💜#關節囊腔內注射!) 23:52(定格看超音波影像和擺位及入針方向) 2.🌹肱二溝處的注射(未言) ~24:14止。 ################ 🔯🔯24:16 棘上肌腱 26:24 肩袖疾患 1.超負荷腱病變 2.修復過程失敗 3.退化性病變 4.與年紀有關的微損傷 26:32 Tendinopathy 26:34 非全層斷斷裂 全厚度斷裂 27:00 27:24關節面側的非全層斷裂左(長軸);右(短軸)。 27:51 28:05 28:48滑囊側的非全層斷裂 28:26 28:50腱內實質的非全層斷裂 29:15 全層肌腱裂 30:16 Sagging peribursal fat sign代表全層斷裂 須小心有時Fat組織看來也類似fibrillar pattern。 31:31 Cartilage sign也代表全層斷裂 32:12 腱肉交界處斷裂 32:46 Oblique nature ################ 33:57 棘下腱 35:38 腱鈣化 36:21 急性鈣化腱炎 36:36 棘上/棘下鈣化腱病灶(短軸) 37:02 Barbotage/急性鈣化病灶處理: 💙💜先以25G針做些局麻, 再以較大口徑18G~20G針穿刺入病灶中心, 反覆[加壓注入(N/S+局麻混合液)(10cc針筒內僅裝4ccN/S) 再抽吸出, 過程中有時須換新針筒] 鈣化混濁物後, 再於#肩峰下滑囊內 注類固醇消炎。 🔯🔯52:59 (定格) GH JOINT掃瞄:[文字大綱]和[示範] 53:03 OA肩 53:34 肩盂唇囊腫Labrial cyst 53:58 五十肩 54:38 五十肩超音波Findings A.54:48肱二腱鞘積液54:48 B.55:04喙肱韌帶發炎、可能可見局灶血流增加、變厚、變緊而短縮 55:04 影片右上方影像中右方結構爲喙突。 C.55:23肩袖間隙處組織增厚，也可能可見局灶血流增加。 D.55:46肱盂韌帶關節囊發炎並增厚。 🔯🔯59:47 GH Joint [掃瞄示範]

2:59 I think you meant hoffa's fatpad, Kager's is located posteriorly to the achilles tendon. Nonetheless keep up the work, loving these video's they help alot!

Thanks for the clear explanation, this helps me alot with my MSK ultrasound studies

Excelente explicación

Nice

You both are my favourite MSK person

What’s the name of the book please ?Msk freak is amazing

thank you , great content

On my 16 inch screen it is impossible to see the plantaris you are pointing out. Tip: if GE machines have the option for full screen mode I would use it for these videos. Or use less depth to enlarge the image.