hi Dr Frank Johnson from Sports Medicine ultrasound having just completed the lumbar facette PRP injections I'm now ready to inject the SI joint now with PRP again we're trying to get into the ligaments surrounding the joint and also get some into the joint so this this is not a traditional Interventional Radiology approach to an SI joint injection having started the lumbar facet injections at 5 cm depth I'm going to maintain my sterile field by simply activating my voice recognition on the claras decrease depth decrease depth decrease gain increase gain there I finally got my final settings now sometimes I'll inject the contralateral SI joint from this side but for our demonstration today I'll be ejecting the near SI joint or the Ipsy lateral SI joint again a small amount of anesthetic first little poke and once again I can't see my needle perfectly but I can very clearly see that with slight oscillations of the needle I can very very clearly see my needle path and then once the needle t touches the ligaments I can feel that too now the number one reason you have to have some sort of image Guidance with this is the following if I slide slightly inferiorly I see a break in the sacrum this is the neural framan at S2 I certainly don't want to put my needle here so I'm going to slide back up until I can very clearly see solid bone on the sacrum and then know I'm safe to inject so I can see my needle trajectory Landing into the recesses of the ASI joint deep to the ligaments and as I inject I can see the fluid fill up in those ligaments so that is an interarticular and intal ligamentous injection into the SI joint
