hi Dr Frank Johnson from Sports Medicine ultrasound I'm here to demonstrate two different features of the clarius l15 the first is the artificial intelligence measuring of the thickness of thin linear tendons we're going to start on the patellar tendon in this healthy soccer player whose knee isn't quite as young as it used to be here we see with the artificial intelligence software on it has identified perfectly appropriately the depth and length of the patellar tendon the voice recognition software is working and if I say freeze as you can see it's actually measured the maximum thickness of the tendon which in an active soccer player with anterior knee pain I really want to know is this patellar tendinopathy is it anterior knee pain from a paramedical cyst or a patellofemoral arthritis so this little AI measurement is a nice little add-on that clarius has done to help make my job as a sport medicine doctor a little bit easier now that we've looked at the patellar tendon it's time to do the intra-articular hyaluronic acid injection again in the old days without ultrasound all we would do is simply slide off the patellar tendon and stick a needle as deep as it'll go into the knee hoping it got past the fat pad but as you can see the fat pad is quite sizable and in some patients the needle would actually stop inside the fat pad and you'd be injecting an expensive hyaluronic acid product into the fat pad and it would never get into the knee moreover it would cause such a profound inflammation and pain in the patient you'd never see the patient again but with ultrasound we can find a beautiful spot in the super patellar recess where the fluid's sitting there easy to access here we can see the patella the quadriceps tendon the Supra patellar fat pad down at the bottom of the screen we can see the femur the prefemoral fat pad and between the two fat pads on the left hand side of the screen and the right hand side of the screen we can see joint fluid we simply rotate the probe 90 degrees and through the sterile gel we can see a nice linear cleft of synovial fluid so for the hyaluronic acid injection all we have to do is get into that and it's inside the knee joint a little bit of freezing and there's my needle coming from right to left now again the advantage of the ultrasound is I can see that it's in the right spot too high I'm in the quadriceps tendon too low and I'm praying this poor gentleman's lateral femoral condyle and nobody likes that so there's a bit of anesthetic into the knee joint into the skin fastest lateralis IT band now to finish off the injection the hyaluronic acid and that's it not just for confirmation what I like to do sometimes is go back into long axis and there we can see that needle sitting in that fluid pocket and to finish it off come back here three two one and there we go again I can see very clearly my needle tip has not inadvertently wandered into the quadriceps tendon there we go that's it hyaluronic acid injection into the knee
