in this situation a lot of people will do ac joint like this like you can see the ace joint really clearly right here you can see she's actually got an ac separation it's widened this area you can see the area the clavicle is there on the left and uh the chromium is on the right and what's interesting of course you can easily just do a center line and come straight in like this however i found what the best way to do this is actually to do it in plane so i'm going to turn my probe 90 degrees and you can actually follow this kind of to find the clavicle there on the left and there's the joint there and actually follow it to the acromion and there's your chromium but if you just come right to the middle it's so easy now just go ahead and place our injection and find it coming in directly let's see there's my needle and actually that's the joint right there so there you go you're right in the joint and that's the disc actually that is the ac joint and so all i have to do is do an injection right there and you've done your ac injection but you do it in direct vision because the problem is if you do it blindly you can go too far and go posterior and miss it or you cannot go far enough and go in here and miss it so this way allows you to get directly into the middle and you can see that we're right in the middle right now so again this is too proximal that's too distal and that's right in the joint so you can see it directly so it isn't i think good enough in this situation because ac joint is so small to do it at a plane like the glenohumeral joint which is so large i think in this situation it's best do in plane like this you
