hi i'm alan hirohara we're going to be doing an injection using uh ultrasound we do an injection of hyaluronic acid into this left knee for a male who has degenerative joint disease and is trying to get some relief from some of this lubricant so we'll be doing this under ultrasound guidance using this clarius device l15 first going to check out the knee take it off freeze take a look down a little bit deeper to be able to see we're going to increase the gain so i can see better here it isn't that deep very seeing very nicely and we can see very well he does have an effusion so we'll be able to give an injection directly in that diffusion you see it's about oh 1.5 centimeter entry point and then angled slightly down to get into it so now we're going to get them cleaned up okay i'm gonna numb it up prepare for the injection i'm gonna put this on make sure we're in the right spot we're happy with our positioning there's a good spot take a picture for recording the video and then entry there we go we're good now they're in the right spot yep in the right spot there we go okay yeah we're in the right spot okay we're good that's it this would be very difficult otherwise without ultrasound this is something that needs to be done on an old channel honestly because that way then we're able to get directly into the knee joint verify we're there you're not in the fat pad you're not in a quad tendon you're not into into a superficial area don't get the bone uh it really ensures we're in the right spot so we can deliver the medication the right area for the most part if you get to the right spot get in the joint it really doesn't hurt so you that's why you always ask the patient how do you feel if he's hurting you might not be in the exact spot you might need to pull back a little bit to make sure you're in the joint he had a little bit of pain on initial injection so i kind of pulled back got in the joint easily and then i was able to flow nice and easily so it's a combination of being able to see and of course talk to your patient but this helps us treat our patients much much better you
