BACKGROUND: Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis.
METHODS: The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia.
RESULTS: Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P < 0.001). Pain did not improve significantly after 120 days with ultrasound-guided corticosteroid injection, whereas significant pain reduction was observed with ultrasound-guided multipuncture.
CONCLUSIONS: Corticosteroid injection provides better short-term results in terms of VAS pain and FFI scores. However, ultrasound-guided multipuncture shows superior outcomes in VAS pain and FFI scores at 120 days.

UNASSIGNED: Phantom and simulation models are valuable training tools for teaching and skill enhancement, yet high costs and limitations of commercial options drive the search for alternatives. This study evaluated the locally sourced phantom models developed for transvaginal and transabdominal gynecologic interventional ultrasound procedures, aiming to cater to the educational needs of OB-GYN ultrasound subspecialists.
UNASSIGNED: Four phantom models simulating biopsy and cyst aspiration/paracentesis through transvaginal and transabdominal approaches, were developed, and assessed by 37 ultrasound subspecialists in obstetrics and gynecology. The respondents, comprising 19 experienced and 18 with limited exposure to guided procedures, utilized an 11-item Likert-scored questionnaire to evaluate the models\' acceptability and suitability for training. Responses were analyzed using descriptive statistics.
UNASSIGNED: Both experienced and less-experienced groups consistently assigned high scores, particularly highlighting the realistic ultrasound image and positioning of structures. The models proved effective in enhancing confidence and proficiency during simulation-based training for probe manipulation, aspiration, and biopsy procedures. While respondents identified concerns like durability and needle track marks, no significant differences emerged between the two groups in evaluating the model.
UNASSIGNED: The overall evaluation of the developed phantom model was positive, showcasing its acceptability among end-users and suitability for training ultrasound-guided procedures in obstetrics and gynecology. The identified issues provide valuable insights for potential improvements in future iterations of the model.

Peripherally inserted central catheter (PICC) placement under real-time ultrasound guidance has emerged as a favorable procedure in children as a method to efficiently obtain central access. Nevertheless, small infants with hemodynamic instability are at high risk of complications and extra precautions are necessary. We present a case of an inadvertent arterial placement of a PICC in a two-month-old infant with dilated cardiomyopathy and decompensated heart failure. Differentiation of arteries and veins under ultrasonographic evaluation may sometimes be difficult when the applied tourniquet pressure exceeds the patient\'s arterial blood pressure. In particular, arterial flow can be easily compromised by applying tourniquet pressure in small children with low blood pressure. A thorough understanding of the upper extremity vascular anatomy, basic scanning techniques, and meticulous preparation especially in small infants with hemodynamic instability are essential for maintaining the safety and efficacy of this procedure.

Background and Objectives: Local infiltration analgesia (LIA) represents a potential approach to reducing pain in patients undergoing total hip arthroplasty (THA). The pericapsular nerve group (PENG) block also provides adequate analgesia for fractures and THA. As most hip surgeries use a lateral incision, affecting the cutaneous supply by branches of the lateral femoral cutaneous nerve (LFCN), the LFCN block can contribute to postoperative analgesia. However, no studies have investigated the effectiveness of supplemental PENG block combined with LFCN block in patients undergoing LIA after hip fracture surgery. Our study aimed to assess the effectiveness of PENG combined with LFCN block following hip fracture surgery in patients who underwent LIA. Materials and Methods: Forty-six patients were randomly assigned to LIA or PENG + LFCN + LIA groups. The primary outcome was the pain score at rest and during movement at 2, 6, 12, 24, and 48 h postoperatively. The total opioid dose for postoperative analgesia was also measured at the same time points. Secondary outcomes included postoperative cognitive function assessment. Results: The median pain scores at rest and during movement were lower in the PENG + LFCN + LIA group throughout the study periods compared to the LIA group, except at 2 h (at rest) and 48 h (during movement) after surgery. The total fentanyl dose was lower in the PENG + LFCN + LIA group at all time points after surgery when compared to the LIA group. Postoperative delirium incidence and the median abbreviated mental test scores were not significantly different between the two groups. Conclusions: The combination of PENG and LFCN blocks may contribute to enhanced recovery for patients undergoing LIA after hip fracture surgery. However, further well-controlled research is necessary to determine the effectiveness of supplemental PENG combined with LFCN block in addressing cognitive deficits in these patients.

To investigate the value of ultrasound-guided percutaneous nephrostomy and nephrostomy tube replacement for treating a solitary kidney with hydronephrosis due to renal tuberculosis.
Clinical data of patients with a solitary kidney with hydronephrosis caused by renal tuberculosis who underwent ultrasound-guided percutaneous nephrostomy in our hospital from January 2011 to December 2022 were retrospectively analyzed. The associated success rate and complications were statistically analyzed, pre- and post-catheterization changes in serum creatinine and blood urea nitrogen levels were compared, success rate and complications of nephrostomy tube replacement in patients with long-term catheterization were statistically analyzed, and the impact of long-term catheterization on patient life was investigated.
Overall, 32 patients aged 17-75 years (average age: 44.1 ± 16.9 years) underwent ultrasound-guided percutaneous nephrostomy. Sixty-three punctures were performed; the puncture success rate was 100%. The levels of serum creatinine and blood urea nitrogen of patients decreased after catheterization, and the differences between the pre-catheterization and post-catheterization were significant (P < 0.05). There were 1, 3, and 12 cases of serious, minor, and fistula-related complications, respectively. The mean duration of the indwelling catheter was 56.7 ± 36.2 (range, 13-120) months. The number of nephrostomy tube replacements was 344 times, and the success rate was 100%. All patients could take care of the puncture point by themselves.
Ultrasound-guided percutaneous nephrostomy and nephrostomy tube replacement have a high success rate and few complications, which can improve the renal function of patients. It is of great value for treating a solitary kidney with hydronephrosis caused by renal tuberculosis.

Endoscopic ultrasound (EUS)-guided coil deployment (EUS-coiling) has been newly developed for treating isolated gastric varices (iGV). This report describes three cases of EUS-coiling for iGV using a 0.035-inch hydrocoil (Azur; Terumo Corp., Tokyo, Japan). When used for EUS-coiling, this hydrocoil provides the following benefits: Its electrically detachable system allows pull back. It has smooth and dense deployment. Moreover, it has a strong blood-flow blocking effect because of its long length and large diameter with internal swelling functions of the hydrogel. Technical success of coiling was achieved in all cases. After coiling, additional treatments such as cyanoacrylate and sclerosant injection were performed as deemed appropriate. All iGVs were obliterated successfully. No adverse event occurred during the procedure or during the mean follow-up of six months. Our findings indicate that this 0.035-inch hydrocoil can be used to treat iGV safely and effectively.

UNASSIGNED: Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided compared to blind coccygeal injection in chronic coccydynia.
UNASSIGNED: Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The patient\'s pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore, the Dallas Pain Questionnaire was assessed before injection; also, four and eight weeks after treatment. The quality of life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire.
UNASSIGNED: The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded groups (P < .001), without any significant difference between the groups (P = .964). Similarly, the Dallas pain scale had a significant decrease at eight weeks after intervention in both groups (P < .001) with no significant difference between the groups (P = .972). Although there was a significant improvement in the patient\'s quality of life in each group eight weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups had any adverse effects associated with the injection.
UNASSIGNED: There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind steroid injection for chronic coccydynia.

UNASSIGNED: Eye-tracking measures attention patterns, which may offer insight into evaluating procedural expertise. The purpose of this study was to determine the feasibility of using eye tracking to assess visual fixation patterns when performing an ultrasound-guided regional anesthesia procedure and to assess for differences between experienced, intermediate, and novice practitioners.
UNASSIGNED: Participants performed an ultrasound-guided sciatic nerve block 3 times on a fresh cadaver model while wearing eye-tracking glasses. Gaze fixation and dwell time on each location were compared between participants. Eye-gaze paths were used to derive a measure of entropy, or how often participants switched gaze fixations between locations.
UNASSIGNED: Five attending anesthesiologists, 5 third-year anesthesiology residents with prior ultrasound-guided regional anesthesia experience, and 5 medical students completed the study. Individuals with more experience were more likely to successfully perform the sciatic nerve block (5/5 attendings, 5/5 residents, 0/5 students; P = .002) and performed the procedure faster (average: attendings 62.6 seconds, residents 106.4 seconds, students 134.4 seconds; P = .089). Participants were progressively faster with practice (Trial 1: 41.8 seconds, Trial 2: 29.2 seconds, Trial 3: 28.9 seconds; P = .012), and the average number of eye shifts per trial decreased from 10.8 to 6.5 to 6 (P = .010). Attending physicians spent significantly less time fixating on the ultrasound monitor compared to trainees (P = .035). Average visual entropy progressively decreased from Trial 1 to Trial 3 (P = .03) and with greater experience (P = .15). There was a strong correlation between entropy and time on task (r(16) = 0.826, P = .001).
UNASSIGNED: Experienced providers make fewer back-and-forth visual fixations, spend less time in the procedure, and demonstrate less entropy during ultrasound-guided regional anesthesia procedures. Mobile eye-tracking has the potential to provide additional objective measures of performance that may help not only determine procedural competence but also distinguish between levels of proficiency.

Objective: To evaluate the efficacy of ultrasound-guided intra-articular injection of triptolide-loaded solid lipid nanoparticle (TP-SLN) for treatment of antigen-induced arthritis (AIA) in rabbits. Material and Methods: Knee joints of 33 New Zealand rabbits with AIA were injected intra-articularly with triptolide (TP: n = 7), TP-SLN (n = 7), betamethasone (BS: n = 7) and dimethyl sulfoxide (DMSO: n = 6). The remaining six rabbits were untreated as the control group. The injection therapy in intervention groups was initiated 1 week after the last immunization in order to avoid irreversible joint damage in the later induction. The ultrasonic scores of the joints were assessed based on synovitis, synovial blood flow and bone erosion. Meanwhile, the correlations of ultrasonic scores and pathological scores were determined. The efficacy and side effects of each group were determined by combining ultrasonic scores, pathological scores, behavior, appetite, weight, joint diameter, skin temperature and biochemical examination. Results: 1) Compared with the control group, the diameters of knee joints of the TP, TP-SLN and BS groups began to reduce 1 week after intra-articular injection (p < 0.01). 2) With the exception of the DMSO group, the interventions were effective in treating synovitis compared with the control group, with TP-SLN and BS being the best. The ultrasonic and pathological scores in synovitis of the TP group were lower than that of model group (Z = -2.726 and -2.530, p < 0.05). The ultrasonic scores differed significantly between BS group and TP-SLN group (Z = -2.17 and -2.360, respectively, p < 0.05) and pathological scores (Z = -2.687 and -2.082, respectively, p < 0.05). 3) Compared with the control group, the TP, BS and TP-SLN were all effective in treating synovial blood flow and bone erosion and there were no significant differences of ultrasonic and pathological scores among them (p > 0.05). The ultrasonic scores of synovial blood flow (Z = -3.033, -2.842, -3.277, p < 0.01) were lower than in the controls. The ultrasonic scores (Z = -2.948, -3.141, -3.210, p < 0.01) and pathological scores (Z = -2.216, -2.505, -2.505, p < 0.05) of bone erosion were also lower than in the model group.4) There were significant correlations between the ultrasonic and pathological scores of synovial inflammation and bone erosion (r = 0.832 and 0.859 respectively, p < 0.001). Conclusions: The therapeutic effect of TP-SLN on arthritis is better than that of TP, but there is no difference between BS and TP-SLN. Therefore, TP-SLN may be used as an alternative to BS in the treatment of rheumatoid arthritis in the future. The ultrasonic and pathological scores showed significant correlation in synovitis and bone erosion. Ultrasound can provide a useful assessment of synovitis in early arthritis.

Background This study aimed to investigate the effect of ultrasound-guided transmuscular quadratus lumborum block (QLB) on postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy (PCNL). Methodology A total of 40 patients aged between 18 and 60 who were classified as American Society of Anesthesiologists status I-II and scheduled for unilateral PCNL were randomly divided into two groups. Patients in Group QLB (n = 20) received a single-shot QLB with 20 mL of 0.25% bupivacaine in the preoperative period. No intervention was performed in the control group (Group C, n = 20). Dermatomes affected by the block procedure were evaluated in the preoperative period in the group of patients who were administered the block procedure. General anesthesia was administered to all patients in both groups. In the postoperative period, opioid consumption, pain scores, side effects related to opioid consumption, and additional analgesic requirements were recorded. Results Opioid consumption was significantly lower in Group QLB compared to Group C at all times (p < 0.05). Postoperative visual analog scale (VAS) scores during the movement were significantly lower in Group QLB compared to Group C at all times (p < 0.05). VAS scores at rest were reported to be significantly lower in Group QLB compared to Group C, except for the eighth and twelfth hours (p < 0.05). The requirement for additional analgesic agents was significantly lower in Group QLB compared to Group C (p < 0.05). Conclusions QLB reduced postoperative opioid consumption and VAS scores by providing more effective analgesia compared to the control group in patients who underwent PCNL.