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So this patient suffers from carpal tunnel syndrome. As you can see here, I'm scanning the median nerve. It's quite large on her. It's kind of inflamed. Here's the flexor retinaculum. And the nerve dives deep. If I trace the nerve backwards, it dives deep in the forearm.
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Now, going the longitudinal way, you can also identify the nerve,
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turning the probe 90 degrees. And you can see the nerve is more hypertrophic than the tendons which are underneath it. Can you wiggle your fingers, please? The tendons move, but the nerve does not. I usually would go proximally and find the cross section right, right before the the flexor retinaculum to inject.
Now in the past we typically would use steroid. However, recent guidelines suggested that you don't need steroids to do a carpal tunnel injection. So I'm just using lidocaine 2% I sometimes use PRP. So I'm using the AI function of my Clara scanner. And I can see the actual median nerve highlighted,
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Which is great for teaching as well as to help confirm. Sometimes the nerve looks like the tendons. So this is something that we use every now and then. In addition it can actually measure the nerve. Okay. Now I'm going to use the coolant. Straightness ties the skin. Just keep your hand back like that. Thank you.
Keeping the nerve centered center guide off pitch.
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Hydro. Dissecting my way across to the nerve.
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Capture image.
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There we go.
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Are we done? That nerve is very large, so I'm not surprised it hurt you. The nerve is inflamed from all the inflammation, so give it some time. It should help. Okay? Okay.