[VIDEO] Case Study: Veterinary POCUS Pathology – See what Inflammatory Bowel Disease Looks Like with Clarius Ultrasound

Dr. Camilla Edwards, DVM, founder of First Opinion Veterinary Ultrasound (FOVU) has shared some great case studies with us in the past, and this new one does not disappoint! 

History: This 19-year-old female neutered domestic short hair cat was seen by a vet because she stopped eating and had some weight loss. Dr. Edwards conducted an abdominal ultrasound with the Clarius C7 HD3 scanner.  

Ultrasound Findings 

As the cat was a very skinny cat, so imaging was done at quite a shallow depth. One of the first things that is quite noticeable is the multiple loops of intestine, with clear visualization of the layers of the intestinal walls. From the lumen centrally, the mucosa, which is hypoechoic, then the submucosa, then the muscularis layer is also hypoechoic. This is surrounded by the serosa, which appears bright white on ultrasound.  

This is an image from a webinar with Dr. Edwards where she describes wall layering in the GI tract.  

In this ultrasound case, the muscularis layer appeared mildly thickened, and  

Dr. Edwards also noticed an enlarged jejunal lymph node. So, what are the next steps? 

To get a better understanding and a diagnosis, she made the decision to perform ultrasound-guided fine needle aspiration (FNA) of the enlarged lymph node. During the ultrasound, Dr. Edwards demonstrates how she plans trajectory, determines needle length, and accurately guides the procedure. 

Video: Abdominal ultrasound identifying pathology and an ultrasound-guided FNA 

Outcome & Discussion 

The findings of thickened muscularis layer throughout the jejunum and an enlarged hypoechoic jejunal lymph node put lymphoma high on the list of differential diagnosis. Another possibility was inflammatory bowel disease. 

FNA of the lymph node required only mild sedation and was not terribly invasive, and in the case of this senior cat, was the kindest and most logical course of action. The aspirate revealed mild reactive lymphoid hyperplasia with no cells suggestive of neoplasia, which was good news for this feline. She would be treated for inflammatory bowel disease, with no worry of neoplasia.

You might be wondering why Dr. Edwards didn’t perform FNA of the intestinal wall, but in this case, it was deemed that the intestinal wall was not thick enough to guarantee a puncture into the lumen and potentially cause peritonitis.

If you’d like to learn more about scanning the jejunum watch this Clarius classroom video with instruction from Dr. Edwards. 

Dr. Edwards uses the Clarius C7 HD3 Vet, which is specifically designed for clinical imaging of small and medium-sized animals. Our Advanced Veterinary Package offers more flexibility for users who need additional workflows for various animal exams. 

To learn about how easy and affordable it is to add Clarius handheld ultrasound to your veterinary practice, visit our Clarius veterinary ultrasound page for product details. Or contact us today to discuss which scanner is right for your veterinarian practice. 

[VIDEO] How Ultrasound Helps You Become a Better Aesthetics Injector

With more than 30 years of experience as a dermatologist and 20 years of injectables expertise, Dr. John Arlette is highly sought-after for his skills in assessing and planning facial rejuvenation. He is also considered a pioneer in the research and use of fillers, educates and trains other physicians on injection techniques and is a regular speaker at international dermatology conferences. 

We were delighted to learn Dr. Arlette uses the Clarius L20 HD3 ultra-high frequency ultrasound system daily and recently had a chance to interview him about his experience with the new Clarius Voice Controls feature. 

I think the addition of the voice controls is brilliant because it answers one of the most common questions that I get during our workshops, and that is, how do I make this work in the practice if I’m working on my own,” he says. “So, instead of actually having to reach up to the touch screen to make a change with what you’re seeing on the screen, by having a voice control, you can use it to capture an image, capture a video clip. Voice Controls enables me to focus on my patient without having to distract myself for mechanical adjustments to the settings on my device.” 

Watch our 5-minute interview with Dr. Arlette to learn and why he thinks ultrasound helps clinicians be better injectors and how adding ultrasound “elevates aesthetics as a specialty”. 

Improve patient safety with ultra-high-definition ultrasound for facial aesthetics 

With exceptional superficial imaging and the new advanced aesthetic preset, the Clarius L20 HD3 is the popular choice for aesthetic clinicians to safely guide procedures like cosmetic fillers and confidently treat complications. It’s the only specialty-designed handheld ultrasound with ultra-high frequency to 20 MHz. Wireless and affordable, it delivers exceptional superficial imaging to 4 cm with an easy-to-use app for your iOS or Android device.  

Clarius Voice Controls is a new feature that’s included with Clarius Membership.  

Learn more on our Clarius for Aesthetics web page. If you’d like to discuss which Clarius scanner is right for your practice, book a virtual demo with a Clarius specialist today!  

[VIDEO] Case Study: Veterinary POCUS Pathology – Feline Stomach Mass 

Dr. Camilla Edwards, DVM and founder of First Opinion Veterinary Ultrasound (FOVU) recently shared a detailed case study using ultrasound to identify a mass in the stomach of one of her feline patients. 

History: This 12-year-old f/n Turkish Van feline presented with a history of vomiting, which improved slightly with prednisolone. She had borderline chronic kidney disease. Naturally, Dr. Edwards used her ultrasound expertise to have a look under the fur! 

Ultrasound Findings 

Imaging in the region of the stomach showed some areas of normal-appearing wall consisting of mucosa, submucosa, and muscularis layers. There is a large area that shows a very thick stomach wall with loss of wall layering. Caudal to the thick stomach wall, there is a large, hypoechoic and rounded lymph node that can be easily identified. 

The thickness of the normal stomach wall is <= 0.25 cm. In this case, the diameter measured 2 cm. The lymph node had a normal measurement at 0.5 cm, but looked atypical. 

Video: Dynamic ultrasound identifying the abnormal area of the stomach and an abnormal adjacent lymph node 

Ultrasound-guided fine needle aspirations (FNA) of the stomach wall were performed in attempt to determine pathology, but the samples were inadequate, and therefore inconclusive. 

The lymph node was not sampled due to its tricky location. There was risk of bleeding with passing the needle through the liver, or peritonitis if the needle passed through the intestines.  

Outcome & Discussion 

In cats, a focal mass in the stomach can be neoplastic or inflammatory, but there’s no way of knowing by just looking. The enlarged, rounded, and hypoechoic lymph node supports a diagnosis of inflammation or neoplasm as well – Dr. Edwards says the larger the node, the more likely the mass is neoplastic. The cat is being weaned off steroids so a biopsy can be performed for a definitive diagnosis. 

Watch this Clarius Classroom video to learn how to systematically perform an ultrasound of the canine or feline stomach and rule out abnormalities of the stomach wall. 

Dr. Edwards uses the Clarius C7 HD3 Vet, which is specifically designed for clinical imaging of small and medium-size animals. Our Advanced Veterinary Package offers more flexibility for users who need additional workflows for various animal exams.

To learn about how easy and affordable it is to add Clarius handheld ultrasound to your veterinary practice, visit our Clarius veterinary ultrasound page for product details. Or contact us today to discuss which scanner is right for your veterinarian practice. 

[VIDEO] Why Clarius Ultrasound is Ideal for Breast Lesion Localization, Pre-Surgical Planning, and Intraoperative Precision

Dr. Muneer Ahmed, an award-winning consultant oncoplastic breast surgeon based in the United Kingdom, says he considers Clarius ultrasound to be the “stethoscope of the breast surgeon.” He uses it before, during, and after treatments at his practice, which comprises the full treatment of surgical oncology, plastic surgical reconstruction, and radiological intervention. 

Breast cancer management from any surgical perspective is really targeted towards lesion excision and handheld ultrasound is an inherent part of my practice,” he explains during a recent interview.

Watch our video interview with Dr. Ahmed to learn more about why he’s a passionate advocate for ultrasound and recommends Clarius ultrasound for breast surgeons. 

Once a lesion is characterized by a radiologist, it is essential for the surgeon to know the exact location of that lesion to prepare for their surgery and allow them real-time visualization intraoperatively. Seeing the exact location of the lesion in the operating room enhances safety. And I think for the well-trained individual surgeon, ultrasound is the most practical modality for real-time visualization.”

In addition to giving him the confidence to precisely locate and monitor the lesion, Dr. Ahmed reports experiencing a higher level of trust in his patients who are able to see the lesion and observe how it changes with treatment.  

The patient pathway, within breast cancer management is a complex one,” he explains. “It is a journey and during that journey, to particularly observe how changes have developed or how treatment response has been evaluated is very useful, particularly in the neoadjuvant chemotherapy setting. And so that can be very reassuring at the bedside, for the patient to know that their treatment is actually yielding fruit and it can be very motivating….” 

Sign up for a Free Webinar to Learn from Dr. Ahmed 

We’re excited to present a free webinar with Dr. Ahmed on May 23, 2023: Enhancing Precision in Oncoplastic Breast Surgery: The Role of Ultrasound in Pre-, Peri- and Postoperative Assessment 

During the live webinar, Dr. Ahmed will share patient cases from office visits to the operating room, to show how you can use handheld ultrasound to accurately and safely plan and guide breast surgeries for the best patient outcomes. 


Enhancing Precision in Oncoplastic Breast Surgery: The Role of Ultrasound in Pre-, Peri- and Postoperative Assessment

Clarius Advanced Breast Package 

Dr. Ahmed uses the Clarius L15 HD3 high-frequency linear scanner at his practice with the Advanced Breast Package, which offers additional customizations for breast examinations and procedures. The software package is included when a membership is purchased with the Clarius L15 HD3 or Clarius L7 HD3 linear scanners.  

To learn which Clarius scanner is right for your practice, book a demo today with a Clarius expert.  

[VIDEO] New Voice-Assisted Ultrasound is «Revolutionary» for Precise Aesthetic Injections

With new AI-powered Voice Controls, which is exclusive to Clarius wireless handheld ultrasound scanners, clinicians never need to put down their scanner mid-procedure or to ask an assistant to adjust their ultrasound image. To maintain a sterile field, adjust their imaging, and capture a video during a procedure, some clinicians performing ultrasound-guided injections have relied on an assistant to control their ultrasound system. Now, they can simply use their voice.

Dr. MJ Rowland-Warmann, a dentist and aesthetic injector based in the United Kingdom, was one of the first Clarius users to test the new Voice Controls while performing ultrasound-guided injections with her Clarius L20 HD3 scanner.  

Being able to have my hands in control of the patient and what I’m doing procedure wise is just revolutionary. It is a remarkable new feature, and it is certainly something that going forward, I could not be without,” she says. “It’s so good. It doesn’t even need a British to American translator. When we had visions in the 80s about what the future was going to be like, we thought it was all going to be about hover cars, but it’s actually all about Clarius Voice Controls!”

Watch this 90-second video to see voice controls in action and to learn more about how Dr. MJ uses Clarius Voice Control in her practice. 

Voice Controls is currently available in English to all Clarius members using any Clarius HD3 wireless ultrasound scanner with the latest 10.3 release of the Clarius Ultrasound App for iOS and Android. Users standing within a meter of the smart device use voice commands to adjust gain and depth, add color mode, freeze images, and capture images and videos. Clarius Voice Controls also work seamlessly with wireless headsets. 

Visit our aesthetics page to learn why Clarius handheld ultrasound is the leading choice for aesthetics practitioners to clearly visualize facial and superficial anatomy in real-time. Or request a virtual ultrasound demo today to learn how high-definition ultrasound imaging with voice controls can improve safety and deliver consistent patient outcomes in your aesthetic practice! 

[VIDEO] Case Study: Veterinary POCUS Pathology – Canine Nephrolithiasis and Bladder Thrombus 

Dr. Camilla Edwards, DVM and founder of First Opinion Veterinary Ultrasound (FOVU) has shared a very interesting case of big bilateral nephrolithiasis and bladder thrombus in a dog. The ultrasound images are impressive, and combined with the dog’s medical history, make for a great detective story.

History: Dr. Edwards was asked to perform an abdominal ultrasound on a 6-year-old female neutered dog who was imported from Greece to the United Kingdom (UK) several years ago. She had a previous diagnosis of Leishmaniasis which is being treated with allopurinol and was recently diagnosed with Capillaria plica (bladder worm), which is uncommon in the UK. 

Ultrasound Findings 

Ultrasound of the left kidney revealed a massive calculus with dense shadowing, occupying the entire renal pelvis. The renal cortex appears normal, and there doesn’t appear to be any evidence of ureteral dilatation suggesting obstruction. The right kidney had a similar appearance. 

The urinary bladder wall appeared to have a normal thickness, but inside the bladder was an irregular mobile mass that fell to the gravity-dependent part of the bladder when the patient was moved. The mass did not show any vasculature with color Doppler. 

Video: Ultrasound of the left kidney and urinary bladder

Outcome & Discussion 

Canine Leishmaniasis is caused by Leishmania parasite and is transmitted by a sandfly bite. It is traditionally only found in the Mediterranean region, which is where our patient came from. 

The treatment for the disease is allopurinol, which has known adverse urinary effects of xanthinuria with renal mineralization, as referenced in this paper from the Journal of Small Animal Practice titled Adverse urinary effects of allopurinol in dogs with leishmaniasis. 

A blood clot in the bladder was assumed to be secondary to the nephroliths in the kidneys.  

The dog was referred for surgery and because the nephroliths measured under six centimeters in length, the surgeons were willing to perform the surgery, which was successful. 

If you’d like to watch some quick instructional videos on how to scan the kidneys and bladder, and other small animal ultrasound demos, go to our Clarius classroom videos where we feature Dr. Edwards and her dog Pippi. 

Video: How to Scan the Right Kidney

Video: How to scan the Left Kidney

Video: How to Scan the Bladder

Dr. Edwards uses the Clarius C7 HD3 Vet, which is specifically designed for clinical imaging of small and medium-sized animals. Our Advanced Veterinary Package offers more flexibility for users who need additional presets and workflows for various animal exams. 

To learn about how easy and affordable it is to add Clarius handheld ultrasound to your veterinary practice, visit our Clarius veterinary ultrasound page for product details. Or contact us today to discuss which scanner is right for your veterinarian practice. 

[WEBINAR] Perform Safe and Accurate Fine Needle Aspirations Using Ultrasound Guidance

Fine needle aspirations (FNA) of abdominal organs and masses are becoming more common in veterinary practices as they can often provide a definitive diagnosis. One of the challenges, though, is obtaining a sample that is diagnostic. The use of ultrasound to guide the needle to the best location is proving to be extremely valuable in increasing the amount of clinically useful samples. 

We recently partnered with Dr. Camilla Edwards of First Opinion Veterinary Ultrasound in a webinar dedicated to fine needle aspirations with ultrasound guidance. Dr. Edwards is a peripatetic veterinary sonographer who teaches ultrasound with IMV-imaging and Celtic SMR and delivers her own courses. She uses ultrasound extensively in her practice and believes that everyone in her profession deserves to have the skills and confidence to use veterinary ultrasound to help improve the care of their patients. 

Read on for highlights, or watch the free on-demand webinar Practical Small Animal Ultrasound: Guiding Safe, Accurate Fine Needle Aspirations

Why Should We Aspirate? 

Fine needle aspiration is inexpensive, fast, and easy to perform. The need for general anesthesia is rare, and because a small gauge needle is used, there are very few complications. Using ultrasound to plan the safest and shortest route to the target, while avoiding blood vessels and other organs helps to minimize risks, reduce repeat sampling, increase diagnostic yield, and avoid complications. 

What Can We Aspirate?

  • A Lesion or mass for cytology 
  • Free fluid for chemistry or cytology 
  • Fluid from an organ lumen for cytology or chemistry 
  • Treatment – abscess drainage, pleural effusion, etc. 

Are There Risks? 

According to Dr. Edwards “The complications are pretty rare, having done lots of fine needle aspirates myself, it’s very, very rare that I’ve had complications, but we do have to be aware of them so that we can minimize the risks”. Some potential complications associated with FNA are: 

  • Hemorrhage and bleeding 
  • Fluid leakage and organ rupture 
  • Neoplastic seeding 

How to Take an FNA 

Practice makes perfect, and Dr. Edwards recommends honing your skills using something that can be imaged with ultrasound. There are simulators and ultrasound phantoms available for purchase, but substitutes like a jelly mold, meat, or tofu work very well, especially if something can be inserted into the medium to mimic a mass. 

Needle size depends on the size of the patient and the depth of the structure being aspirated. Typically, 21- or 23-gauge needles are suitable. For multiple samples at the same site, use the same syringe, but a new needle for each sample.

Watch this short video to see how Dr. Edwards does it.

Once you’ve guided your needle to the target area, use a “woodpecker technique” to take multiple samples – the more samples taken, the more likely a diagnosis will be achieved. Immediately after the procedure, repeat imaging with ultrasound to ensure there’s no evidence of bleeding or organ damage, and monitor accordingly. 

In the webinar, Dr. Edward presents 2 interesting cases complete with patient history and high-resolution ultrasound imaging of pathology prior to FNA. She describes the ultrasound findings, pre-procedure preparations, planning the trajectory of the needle, and live videos showcasing the ultrasound-guided FNA procedures. 

For more information about Dr. Edwards and the educational services she provides, visit her website, or get in touch at camilla@fovu.co.us. 

Clarius Wireless Ultrasound for Veterinary Practice 

Dr. Edwards uses the Clarius C7 Vet HD3 scanner in her small animal practice. To learn more about how you can add wireless ultrasound to your practice, visit our Veterinary Specialty Page. There you’ll have access to additional webinars and classroom videos. Learn about the Advanced Veterinary Package provides additional workflows for a wide variety of animal examinations. 

Our new Clarius HD3 Vet scanners are smaller and lighter. To find out which scanner is best for your practice, contact us today, or request a virtual ultrasound demo

[VIDEO] Why Every Urologist Should Use Clarius Ultrasound

I wish I had this sooner,” says Dr. Kevin Zorn, a urologist practicing at the University of Montreal who recently spoke to us about his experience using Clarius ultrasound at his clinic during the past 8 years. “This little guy here has dramatically changed the efficiency of our clinic.”

Before he started performing his own ultrasound exams, Dr. Zorn typically sent his patients for imaging prior to deciding whether they needed surgery or alternative treatment. With access to ultrasound in his pocket, he can perform an exam in three minutes for most patients during a first visit.

The time my patient has to spend to come to my office, find parking and wait to see me is precious and my goal is to spare them having to come back for a second visit just for ultrasound. I only have a certain amount of time in my life to dedicate to my practice so this simple tool adds huge value by making me more efficient.”

Dr. Zorn was one of the first urologists to use the first-generation Clarius handheld wireless ultrasound in 2016. He considers the Clarius C3 HD3 workhorse for everyday use to examine the penis, scrotum, kidneys, and bladder. He also uses the Clarius EC7 HD3 endo cavity transducers for biopsies and minimally invasive prostate procedures.

I find [the Clarius] superior to the other POCUS. That’s why I’ve chosen and continue using the Clarius, as well as this [Clarius Cloud] reporting system. So, the resolution and the imaging are as good as major cart based. And again, just the modularity, the access, and the speed to get it up and operational is fantastic.”

Watch our 5-minute video interview with Dr. Zorn to learn about how Clarius ultrasound compares to other ultrasound systems he has used.

Watch a Demonstration of a Bladder and Prostate Ultrasound Exam

In this Clarius Classroom video, Dr. Zorn assesses the urinary bladder and prostate of a patient with lower urinary tract symptoms using his Clarius C3 HD3 wireless curvilinear scanner. Watch a renal ultrasound exam here.

Clarius Ultrasound for Urology

As Dr. Zorn will attest, Clarius wireless ultrasound scanners are ideal for your office or hospital practice with accurate, high-definition imaging readily available for diagnosis and therapy. Clarius offers three wireless scanners that are suitable for urology: the C3 HD3 transabdominal ultrasound for genitourinary imaging, the EC7 HD3 for transrectal and transvaginal ultrasound, and the L15 HD3 for superficial imaging. Visit our urology specialty page to learn more!

Book a Virtual Demo

We invite you to book a virtual demo to discuss which of our specialty ultrasound scanners is right for your practice.

New AI-Powered Voice Controls, MSK AI, and More Enhancements in Clarius V10.3

With the release of Clarius Ultrasound App 10.3 today, we’re delighted to announce new Clarius members-only features, designed to make your ultrasound experience more efficient and user-friendly.

Members, Meet Your New Hands-Free Assistant

Introducing our new AI-powered Voice Controls, enabling a hands-free experience while you scan. There’s no need to touch your screen. Simply ask your scanner to «freeze, increase gain, decrease depth, capture image, capture video, color mode» and more.

Until now, Voice Controls has just been available as a premium option on select traditional ultrasound systems used for surgeries and other interventional procedures. Clarius is the only handheld ultrasound company offering this feature today, and it’s available on all ten Clarius HD3 wireless ultrasound scanners for Clarius members with the latest 10.3 release of the Clarius Ultrasound App for iOS and Android.

Voice Controls is an absolute game changer for me when I’m doing a procedure using Clarius,” says Dr. Alan Hirahara, an orthopedic surgeon specializing in sports medicine. “When I have two hands full, one with the ultrasound and the other with a scalpel or syringe, I would need an assistant to manipulate something on screen, or to document the procedure, so I don’t contaminate the sterile field. Now I just say ‘capture video, increase gain, or color mode’. There’s so much we can do, and the nurse is free to do something else in the clinic.”

Voice Controls will initially be available in English only. It is one of many advanced AI features available today with Clarius Membership. To develop Voice Controls, Clarius recorded thousands of voice commands and used machine learning algorithms to teach the software to recognize and perform key imaging functions. Users standing within a meter of the smart device will be able to use voice commands to adjust gain and depth, freeze images, switch imaging modes, and to capture images and video. Clarius Voice Controls also work seamlessly with wireless headsets.

I think the addition of the Voice Controls feature is brilliant,” says Dr. John Arlette, a dermatologist whose practice is focused on injectable therapies, cosmetic therapy, and aesthetic management. “Instead of reaching for the touch screen to make a change with what you’re seeing on the screen, you can use Voice Controls to capture an image or capture a video clip. Procedures are faster and I can focus on the patient instead of being distracted by mechanical adjustments to the settings on my device. The voice-activated mechanism is especially an advantage to the practitioner who’s working on their own.”

Clarius has tested the new feature with clinicians from a variety of specialties including those who use ultrasound for diagnosing and treating MSK ailments and sport injuries, plastic surgery, anesthesia, aesthetics, pain management, orthopedic surgery, and veterinary medicine.

Voice Controls have proven to be useful on traditional ultrasound systems and we’re excited to offer this premium feature to all Clarius members,” says Kris Dickie, Vice President of Research and Development at Clarius. “Our goal is to continue making innovative features available on all Clarius handheld scanners for a small fraction of the cost that is currently the norm for premium ultrasound systems. Every clinician should have access to a high-quality ultrasound system to improve patient care.”

Watch Voice Controls in Action

Introducing MSK AI for Easier Exams (USA only)

Also, available now to members in the United States using a Clarius Scanner with the latest Clarius 10.3 App: the first FDA-cleared AI ultrasound application that identifies, measures, and labels tendons to help you perform musculoskeletal exams faster. Available with the Advanced MSK Package, MSK AI is especially helpful for novice ultrasound users, making learning ultrasound anatomy easier. By automatically displaying the thickest width, it also helps streamline exams and supports serial studies with consistent measurements of patellar, Achilles, and plantar facia tendons.

Discover Additional Features and Enhancements Included with Clarius 10.3 App

Dynamic Spectrum Resizing

Now, you can dynamically resize spectrums during Doppler examinations, giving you more control over your image display. Easily adjust the spectrum size to your preference, allowing for better visualization and a more personalized scanning experience.

Veterinary OB Growth Tables

The new Veterinary OB growth tables provide a valuable resource for veterinary practitioners performing pregnancy ultrasound examinations. With growth tables for both dogs and cats, you can now obtain more accurate estimations of gestational age and fetal growth, improving patient care for your animal patients.

Enhancements and Fixes

  • Experience smoother navigation with an improved modes and tools menu.
  • Stay organized with our new user profile page, ensuring specialty selection when creating an account.
  • Get rapid, high-quality imaging with our fast frame rate mode for cardiac color Doppler examinations.
  • Enjoy BBL preset imaging improvements for the L15.

Clarius Users, We Appreciate Your Feedback

We hope you enjoy your experience with the Clarius App. If you have any questions or feedback, please reach out to our friendly support team at support@clarius.com. Your feedback matters. Thank you for being a part of the Clarius community!

Book a Virtual Demo

If you’re interested in joining the Clarius Community, we invite you to book a virtual demo to discuss which of our specialty ultrasound scanners are right for your practice.

[WEBINAR] Learn Proven Ultrasound Guided Blocks for Knee Surgery – IPACK Block 

For total knee replacement and ACL surgeries, the goal of the IPACK (Infiltration between the Popliteal Artery and the Compartment of the Knee) block is to block the terminal branches of the obturator and tibial nerves in the posterior knee space, sparing the main trunks of the tibial and common peroneal nerves, thereby maintaining the sensorimotor function of the leg and foot (decreasing foot drop). 

In a recent webinar,  Dr. Greg Hickman, Medical Director and Anesthesia Director at the Andrews Institute Ambulatory Surgery Center in Florida, shared his ultrasound-guided nerve block techniques for more effective regional blocks in patients undergoing knee surgery. Read on for highlights of the IPACK block.   

Dr. Hickman has perfected his block techniques over the past 30 years and enjoys sharing what he’s learned during webinars like these and through his popular regional guided anesthesia educational website Blockjocks.com.  He believes ultrasound improves the speed of block procedures and also improves the duration of blocks as more medication reaches the target nerve.  

How to Perform an Ultrasound-Guided IPACK Block 

Dr. Hickman prefers a lateral approach for this injection, with the patient supine and the leg elevated enough so he can place the ultrasound scanner behind the knee.  

It’s easy to visualize the where the popliteal artery and femoral condyles at this level, so from here, slight movement of the scanner proximally will identify the target area for injection.”   

One of the biggest advantages of the lateral approach technique is the excellent visualization of the needle. This is because the needle stays in plane and parallel to the linear ultrasound scanner, which is optimal for ultrasound guided injections.”   

Watch this video demonstration of the IPACK block in Dr. Hickman’s patient.   

The combination of the adductor canal continuous catheter with the IPACK block showed equivalent analgesia compared to the femoral nerve block, reduced opioid consumption, improved physical therapy performance, and earlier hospital discharge. 

Novel Regional Techniques for Total Knee Arthroplasty Promote Reduced Hospital Length of Stay 

 Thobhani S, Scalercio L, Elliott CE, Nossaman BD, Thomas LC, Yuratich D, Bland K, Osteen K, Patterson ME. Novel Regional Techniques for Total Knee Arthroplasty Promote Reduced Hospital Length of Stay: An Analysis of 106 Patients. Ochsner J. 2017 Fall;17(3):233-238. PMID: 29026354; PMCID: PMC5625980.) 

Clarius Ultrasound for Regional Anesthesia 

Dr. Hickman uses the Clarius L15 HD3, which provides detailed MSK and nerve imaging down to 7 cm for regional anesthesia procedures.  

Wireless, ultra-mobile, and with high-definition imaging, Clarius is the ideal handheld ultrasound system for anesthesiologists who are on the move from one patient to the next for regional blocks and post-operative visits. Clarius HD3 ultrasound scanners deliver the clear imaging and power you expect from a traditional system for a fraction of the cost.   

Contact us today to schedule a virtual demo to discuss which scanner is right for your anesthesiology practice.