I hope this reaches a wide audience of inquiring practitioners. I watched for the entertaining analysis. I bet that video took some time to create and it shows. Thanks Brandon Ramakko.
I do plan to make a follow-up summarizing the usefulness of ultrasound in practice. Always so much to do. In skilled hands, ultrasound is as good as an MRI for rotator cuff tears. Even in amateur hands it is virtually 100% accurate at diagnosing carpal tunnel syndrome or plantar fasciitis/fasciosis, etc... Just those two examples I've had at least a dozen people come in "diagnosed" by their MD, only to have the ultrasound prove that their problem must stem from another diagnosis.
Really appreciate this video! Potentially looking to buy a Clarius soon. How effective is the L15 for visualizing the posterior glenohumeral joint, especially for injections? I'm concerned about its depth penetration vs L7, especially given your previous explanation about hip
I've never had an issue with the posterior glenohumeral joint. There are some tricks to get better images of deeper structures (like turning off compound imaging and turning on trapezoid view can give you better field of view. I would say maybe up to 7cm deep you could still image. I've scanned some weightlifters which did surprise me at first, having to increase the depth more than I thought. but I was able to image just fine in the end. The injection is typically lateral to medial aiming to near the posterior labrum so you just have to go through the superficial tissue, deltoid, and a tendon. Maybe you are a pro, so forgive my pointers if so, but typically you just have to bring the needle to hyaline cartilage, you don't have to jam it under the labrum, so the target region is broader than most people think. If you are touching hyaline cartilage you are intraarticular. Now in the cayman islands I didn't get too many obese patients so I can't promise it would work on everybody.
@@brandonramakko Thanks for the info! I practice PM&R in California and my patients often have larger body habituses, so we often use the curvilinear probe for our posterior glenohumeral joint injections. I've used linear for those injections too but found needle visualization to be tougher especially with more prominent SQ tissue and steeper trajectory (as expected vs using curivilinear). I'll probably buy a L15 in addition to a convex probe after watching your video. Thanks again!
Okay, so I didn't renew my subscription and I then had my tablet disconnect from the internet (not needed since I wouldn't be using the cloud). Now I'm not working on patients right now as I took a career break to work on my ultrasound program (msk-pocus-training.trainercentralsite.com/ ), but today it asked to go onto the internet to check my subscription status. You would think this would just disable the premium/subscription features but no, the ultrasound won't work at all until it gets internet access. This... and the forced updates interfering with patient exams... and the garbage cloud software.... and the requirement to have GPS location to use it..... So ridiculous. What happens if I was volunteering somewhere in the middle of Africa! Again, the unit itself is great.... but this is the last straw. I'll be buying either a Chinese double head transducer or the GE one to use and review hopefully soon. I'm never giving Clarius more of my money even if that means my unit will be worse and it will make diagnosis more difficult. I feel like they are holding my patient's health hostage. Well, they say you shouldn't give in to terrorist demands.
I'm even madder. They changed things since I purchased my unit and local saving is no longer a basic feature. YOU CAN'T SAVE THE EXAM WITHOUT A SUBSCRIPTION NOW!!! I guess I need to screenshot everything now. I'm so mad, no more splitscreen, and I use split screen all the time. No more spectral doppler -which was used as part of my DVT exam. You can't buy these features, you have to pay for their subscription. I wonder if I will end up caving to their demands for the good of my patients but they say you shouldn't deal with terrorists.
I hope this reaches a wide audience of inquiring practitioners. I watched for the entertaining analysis. I bet that video took some time to create and it shows. Thanks Brandon Ramakko.
I do plan to make a follow-up summarizing the usefulness of ultrasound in practice. Always so much to do. In skilled hands, ultrasound is as good as an MRI for rotator cuff tears. Even in amateur hands it is virtually 100% accurate at diagnosing carpal tunnel syndrome or plantar fasciitis/fasciosis, etc... Just those two examples I've had at least a dozen people come in "diagnosed" by their MD, only to have the ultrasound prove that their problem must stem from another diagnosis.
Really appreciate this video! Potentially looking to buy a Clarius soon. How effective is the L15 for visualizing the posterior glenohumeral joint, especially for injections? I'm concerned about its depth penetration vs L7, especially given your previous explanation about hip
I've never had an issue with the posterior glenohumeral joint. There are some tricks to get better images of deeper structures (like turning off compound imaging and turning on trapezoid view can give you better field of view. I would say maybe up to 7cm deep you could still image. I've scanned some weightlifters which did surprise me at first, having to increase the depth more than I thought. but I was able to image just fine in the end. The injection is typically lateral to medial aiming to near the posterior labrum so you just have to go through the superficial tissue, deltoid, and a tendon. Maybe you are a pro, so forgive my pointers if so, but typically you just have to bring the needle to hyaline cartilage, you don't have to jam it under the labrum, so the target region is broader than most people think. If you are touching hyaline cartilage you are intraarticular. Now in the cayman islands I didn't get too many obese patients so I can't promise it would work on everybody.
@@brandonramakko Thanks for the info! I practice PM&R in California and my patients often have larger body habituses, so we often use the curvilinear probe for our posterior glenohumeral joint injections. I've used linear for those injections too but found needle visualization to be tougher especially with more prominent SQ tissue and steeper trajectory (as expected vs using curivilinear). I'll probably buy a L15 in addition to a convex probe after watching your video. Thanks again!
Okay, so I didn't renew my subscription and I then had my tablet disconnect from the internet (not needed since I wouldn't be using the cloud). Now I'm not working on patients right now as I took a career break to work on my ultrasound program (msk-pocus-training.trainercentralsite.com/ ), but today it asked to go onto the internet to check my subscription status. You would think this would just disable the premium/subscription features but no, the ultrasound won't work at all until it gets internet access. This... and the forced updates interfering with patient exams... and the garbage cloud software.... and the requirement to have GPS location to use it..... So ridiculous. What happens if I was volunteering somewhere in the middle of Africa! Again, the unit itself is great.... but this is the last straw. I'll be buying either a Chinese double head transducer or the GE one to use and review hopefully soon. I'm never giving Clarius more of my money even if that means my unit will be worse and it will make diagnosis more difficult. I feel like they are holding my patient's health hostage. Well, they say you shouldn't give in to terrorist demands.
I'm even madder. They changed things since I purchased my unit and local saving is no longer a basic feature. YOU CAN'T SAVE THE EXAM WITHOUT A SUBSCRIPTION NOW!!! I guess I need to screenshot everything now. I'm so mad, no more splitscreen, and I use split screen all the time. No more spectral doppler -which was used as part of my DVT exam. You can't buy these features, you have to pay for their subscription. I wonder if I will end up caving to their demands for the good of my patients but they say you shouldn't deal with terrorists.
My advice to you is to install lineageos on your tablet and spoof the gps. Or just don't use a company that is tracking you so much.