Injection - Intervention - Procedure technique descriptions

Reference: https://bjsm.bmj.com/content/b...

Reference: Msus Injection Recommended Musculoskeletal And Sports Ultrasound

Procedure technique descriptions

Aponeurotomy Cutting an aponeurosis, either completely or incompletely, using a needle, scalpel or other device.

Aspiration The act of removing fluid, calcification or other crystalline material, blood, pus or other substance from the body typically using a needle and syringe, catheter oranother device

Barbotage Repeated injection and aspiration of fluid to break up and remove calcification, usually within a tendon

Brisement The injection of fluid into the space between a tendon and its paratenon or sheath; brisement has also been used to refer to injection of saline or other fluid into a joint to break down adhesions (eg, in treatment of adhesive capsulitis).

Debridement The removal of necrotic, degenerative or infected tissue from a region or given tissue of the body.

Dry needling A procedure, generally used as part of manual physical therapy, where a small gauge needle is inserted into a muscle or other soft tissue structure to treat myofascial pain

Fasciotomy Cutting fascia, either completely or incompletely, using a needle, scalpel or other device

Fenestration The act of repetitive puncture of a soft tissue structure with a needle or other device

Fragmentation The use of a needle or other device to break up calcified and/or bony tissue

Hydrodissection Technique by which saline or other sterile fluid is injected to separate tissues or tissue planes from each other

Injection The act of delivering a fluid or other substance into the body, typically using a needle and syringe, catheter or another device.

Lavage Washing out using saline or other sterile solution; irrigation is an acceptable alternate term.

Neurolysis There are distinct definitions of neurolysis. An appropriate modifier is recommended to clearly describe the procedure performed.

Chemical neurolysis The application of chemical agents to a nerve in order to cause temporary or permanent degeneration of targeted nerve fibres.

Hydroneurolysis The injection of saline or other sterile fluid to free nerves from surrounding tissue/adhesion; the term ‘nerve hydrodissection’ is an acceptable alternate term.

Surgical neurolysis The surgical freeing of nerves from surrounding tissue/adhesion

Physical neurolysis The application of physical energy (eg, heat or cold) to a nerve in order to cause temporary or permanent degeneration of the targeted nerve fibres

Plantar fasciotomy Cutting the plantar fascia, either completely or incompletely, using a needle, scalpel or other device.

Tendon scraping The process of abrading the surface of a tendon or paratenon with a needle, scalpel, or other device, with the goal of separating the tendon from neovessels, neonerves and/or adjacent soft tissues.

Tenotomy Cutting tendon tissue, either completely or incompletely, using a needle, scalpel or other device

Trigger finger release Cutting the pulley and associated tendon sheath responsible for the stenosis using a needle, scalpel or other device

Terms to avoid

Minimally invasive, ultraminimally invasive and microinvasive These are relative and imprecise terms without formal definitions. Therefore, their use is not recommended. The exact procedure should be described including technique and tool(s) used.

Needling This is an inconsistent term that has been used to describe a range of procedures from dry needling of myofascial trigger points to tenotomy or fasciotomy procedures. The use of a more precise term is recommended. ‘Needling’ should only be used in conjunction with ‘dry needling’ as previously defined.

Peppering This term has been used to describe a type of fenestration procedure (often involving a tendon) alone or in conjunction with an injection. The use of more precise terms such as ‘tenotomy’, ‘fasciotomy’ or ‘fenestration’ is recommended.

Percutaneous This term refers to a procedure performed through the skin. Due to lack of specificity associated with this term, its use in isolation is not recommended. Rather, the exact procedural technique should be described including tool(s) used and approach.

Template for documenting a US-guided interventional procedure

1. Patient’s name and other identifying information.

2. Date and time of intervention.

3. Ordering provider.

4. Location and contact information of facility in which the US-guided procedure was performed.

5. Clinical history/indication.

6. Technical.

–– Device.

–– Medications or other administered substances, including lot number, if applicable.

7. Procedure performed (eg, knee joint aspiration, carpal tunnel release, etc).

8. Injection/aspiration/procedure details.

–– Informed consent and time-out statements.

–– Description of preinjection images.

–– Target images.

–– At-risk structures.

–– Description of procedure.

–– Conditions under which procedure was performed (sterile, aseptic, etc).

–– Type of anaesthesia.

–– Description of approach—in-plane/out-of- plane, long axis or short axis to the target, medial or lateral to the target.

–– Description of the procedure performed including names and amounts of medications or other substances used if applicable. Describe any devices used.

–– Specimen description, type and amount removed if applicable.

–– Blood loss (if applicable).

–– Complications.

–– How the procedure was tolerated

9. Disposition and follow-up plans