this is a patient who suffers from shoulder pain uh as well as neck pain she has an x-ray of the shoulder and neck that's consistent with osteoarthritis she has multi-level disc disease and she's been suffering for over 3 months with pain I'm first going to scan her braal plexus at the super clavicular falsa and I see the subclavian artery and the first rib with the lungs below it see the pulsating artery color mode decreased depth B mode so now we see the nerves around the artery and sometimes we can trace the suprascapular nerve as it leaves the brachial plexus right here and goes more posteriorly towards the notch of the scapula and then under the supinatus muscle and we lose it as it gets deeper under the trapezius posteriorly over here here's a subclavian artery and the nerves and the super scapular nerve breaks off and inates to supinatus muscle infraspinatus muscle and 80% of the shoulder sometimes we can see it clearly break off other times it's more difficult now I'm going to perform a superp scapular nerve block first I'm going to localize the skin more pinching pressure may feel some pain in the shoulder right now okay and I just broke through the ligament I'm going to aspirate and inject well Air One in and we lose visualization of the nerve once the air goes in unfortunately but you can at least see that the needle is placed right at the transverse scapular ligament and there is spread under the ligament as well I'm going to remove the needle and we're done
