(Musculoskeletal Medicine) Jonathan S. Kirschner MD, FAAPMR, RMSK (auth.), David A. Spinner, Jonathan S. Kirschner, Joseph E. Herrera (eds.) Atlas of Ultrasound Guided Musculoskeletal Injections Sprin
164 pág.

(Musculoskeletal Medicine) Jonathan S. Kirschner MD, FAAPMR, RMSK (auth.), David A. Spinner, Jonathan S. Kirschner, Joseph E. Herrera (eds.) Atlas of Ultrasound Guided Musculoskeletal Injections Sprin


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Musculoskeletal Medicine
Atlas of 
Ultrasound Guided 
Musculoskeletal 
Injections
David A. Spinner 
Jonathan S. Kirschner 
Joseph E. Herrera Editors
 Musculoskeletal Medicine 
Series Editors
Grant Cooper \u2022 Joseph E. Herrera 
For further volumes:
http://www.springer.com/series/7656
 
 David A. Spinner \u2022 Jonathan S. Kirschner 
 Joseph E. Herrera 
 Editors 
 Atlas of Ultrasound Guided 
Musculoskeletal Injections 
 Editors 
 David A. Spinner, DO, RMSK 
 Department of Anesthesiology - Pain Medicine 
 Beth Israel Deaconess Medical Center
Arnold Pain Management Center 
 Harvard Medical School
Brookline, MA 
 USA 
 Jonathan S. Kirschner, MD, FAAPMR, RMSK 
 Interventional Spine and Sports Medicine Division
Department of Rehabilitation Medicine
Icahn School of Medicine at Mount Sinai 
 New York, NY 
 USA 
 Joseph E. Herrera, DO, FAAPMR 
 Interventional Spine and Sports Medicine Division
Department of Rehabilitation Medicine
Icahn School of Medicine at Mount Sinai 
 New York, NY 
 USA 
 ISBN 978-1-4614-8935-1 ISBN 978-1-4614-8936-8 (eBook) 
 DOI 10.1007/978-1-4614-8936-8 
 Springer New York Heidelberg Dordrecht London 
 Library of Congress Control Number: 2013954547 
 © Springer Science+Business Media, LLC 2014 
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Series Editors
Grant Cooper, MD 
Princeton Spine and Joint Center 
Princeton, NJ 
USA
Joseph E. Herrera, DO, FAAPMR
Icahn School of Medicine at Mount Sinai 
New York, NY 
USA
 Grant me an opportunity to improve and extend my training, since there is no 
limit to knowledge. Help me to correct and supplement my educational 
defects as the scope of science and its horizon widen day by day. 
 Moses ben Maimon (Maimonides) 
 Mishneh Torah. IV, 19 
 
 Dedicated to my wife, Jessica, and daughter, Shirley, who spent nights and 
weekends without me so that I could bring this book to completion. 
 To my sister, Randi, and mother, Ricki, for a lifetime of setting the bar high 
and leading by example. 
 And to my father, Charles, who had an unequivocal belief in me to succeed. 
When I scored a 93 on a test, he asked what happened to the other 7 points, 
ensuring whatever the score on a test, I understood the material for it would 
make a difference. No matter the cost or family adversity, my education would 
never be sacrifi ced. He believed that one day I would help people in their 
suffering. I hope this helps. 
 David A. Spinner, DO, RMSK 
 To those who I have learned so much from, my parents, Bruce and Gwenn; 
my sisters, Greta and Kaye; my brother, Eli; my wonderful friends; my 
mentors; and my students. 
 Jonathan S. Kirschner, MD, FAAPMR, RMSK 
 This book is dedicated to my wife, Sandra, and children, Alex, Mikhayla, and 
Andrew, for their love and encouragement. To my parents, Eduardo and Rosario, 
and my sister, Sacha, for their sacrifi ce and unconditional support. 
 Joseph E. Herrera, DO, FAAPMR 
 
ix
 I am very fortunate to have had the opportunity to write the foreword for this excellent piece 
of work, Atlas of Ultrasound Guided Musculoskeletal Injections, inspired and created by Drs. 
Spinner, Kirschner, and Herrera. 
 The use of ultrasound to diagnose and treat musculoskeletal conditions is an evolving and 
incredible medical skill. We now have the ability to go beyond palpation and physical exami-
nation maneuvers and truly visualize neuromusculoskeletal structures and their spatial rela-
tionships and dynamic interactions. We can do focused visual evaluations seeing structures 
and specifi c tissue planes and dynamically visualize obvious and subtle defects. 
 Structures such as nerves and tendon sheathes can now be clearly visualized while we direct 
our treatments more precisely adjacent to them while avoiding injecting within their substance. 
Equally, if not more importantly, we can visualize vascular and other structures we want to 
avoid. This leads to improved, safer, and more comfortable treatments. 
 Ultrasound is also an evolving supplemental tool in the interventional spine fi eld. For the 
last several decades, our spinal treatments have improved in effi cacy and safety due to fl uoro-
scopic techniques. They have improved even further with contrast installation and more 
recently with digital subtraction usage. I anticipate that these spinal ultrasound techniques will 
not replace, but supplement , fl uoroscopy in the evolving spinal intervention treatment fi eld. As 
the ultrasound technology and resolution improve, we will get improved visualization of the 
nerves we want to treat and the vessels we want to avoid, along with the landmarks we know 
from fl uoroscopically performed spinal procedures. 
 This Atlas is an enormous and distinctive contribution to the evolving ultrasound fi eld. It 
comprises essential musculoskeletal ultrasound topics important to physiatrists, sports medi-
cine physicians, orthopedists, rheumatologists, and others devoted to the treatment of muscu-
loskeletal disorders. The Atlas is unique since it also presents evolving understanding of spinal 
ultrasound options and controversial subjects including ultrasound-guided spasticity, myofas-
cial pain syndrome, and biologic treatments. 
 This Atlas will be sure to have a profound impact on the education of musculoskeletal spe-
cialists, residents, and fellows. This Atlas is a representation of the commitment Drs. Spinner, 
Kirschner, and Herrera have as passionate teachers and educators. They have gone to great 
length and detail to present a plethora of appropriate musculoskeletal references and evidence- 
based medicine relevant to each procedure. 
 This Atlas is truly a work of art based on what now would seem simple premises. This is a 
 succinct visual reference with fi gures, pictures, and diagrams to facilitate an easy understand-
ing of the core concepts on patient presentation, relevant anatomy, and sonoanatomy.