Basic considerations before injections and scanning techniques

Portable and affordable high-resolution ultrasound (US) machines have accelerated the interest in the use of US guidance for interventional pain procedures. The advantages of ultrasonography over fluoroscopy are as follows: (1) no radiation exposure to both the patient (especially with repeated procedures) and the practitioner; (2) real-time visualization of soft tissues (nerves, muscles, tendons, and vessels); and (3) needle-tip advancement relevant to surrounding structures and local anesthetic spread. Even though the target structure is identified correctly, there is still the challenge of placing the needle tip in the optimum site. To encourage pain physicians to use US for interventional procedures, this article aims to review some basic aspects of scanning and imaging techniques.