this is Gerard Gerard's been with me for a while I've been treating him for shoulder arthritis he's done quite well with visco supplementation of the shoulder the the goal is to avoid excessive steroid injections and he suffers from multiple orthopedic problems hip arthritis as well he's a working man he needs to stay active and working so the ultrasound enabled me to guide my injections into the glender humeral joint to deposit visco supplement so notice Gerard has swelling more worse on the left than the right side it looks like it's a chromio clavicular joint here's his clavicle I'm going to scan it with the ultrasound and this is a cross-section of the clavicle the hyperlucent bone with the bone Shadow behind it capture image B mode Center guide I had to remove that line in the center I'm going to scan lateral and now I'm approaching that mass which is probably just an inflamed joint on Imaging it looks like it's it's fluid filed uh based on the fact that it's hypol suent am I hurting you J no capture image decrease depth know how easy is to control the machine with my voice so what I'm going to do is I'm going to drain the uh fluid from this Mass right here and I'll try to do it under ultrasound guidance capture image capture image capture video see the bevel of my needle here's an image of the a chromal clavicular joint and this lesion is right above it so it might be some sort of inflammation from The Joint um but I can't drain it unfortunately right okay here's a picture of the joint space you have the clavicle over here and scanning more loud you have the acromium and this is the acromial clavicular joint
