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Ultrasound-Guided Injection of the Intrapelvic Portion of the Obturator Internus in a Cadaver Model

Authors
 Sang Chul Lee  ;  Dong-wook Rha  ;  Hee-Jin Kim  ;  Hun-mu Yang  ;  Sang-Hee Lee  ;  DongJin Koh 
Citation
 REGIONAL ANESTHESIA AND PAIN MEDICINE, Vol.39(4) : 347-350, 2014 
Journal Title
 REGIONAL ANESTHESIA AND PAIN MEDICINE 
ISSN
 1098-7339 
Issue Date
2014
MeSH
Aged ; Cadaver ; Humans ; Injections, Intramuscular/methods* ; Male ; Muscle, Skeletal/diagnostic imaging ; Needles ; Pelvic Floor/diagnostic imaging* ; Ultrasonography
Abstract
BACKGROUND AND OBJECTIVES: Musculoskeletal dysfunction of the pelvic floor is common. One of the intrapelvic muscles, the obturator internus (OI), can be substantially stressed during its sharply angulated exit from the pelvis. However, there may be considerable overlap between symptoms and signs arising from the OI and other potential pain generators including the levator ani in the pelvic region. Accurate diagnosis for the OI might permit more efficient treatment combined with OI-specific exercise and behavior modification. Therefore, we hypothesized that ultrasound (US)-guided needle insertion in the intrapelvic portion of the OI would be accurate when a pararectal approach is used for diagnostic and therapeutic purposes. METHODS: Bilateral US-guided intramuscular injections in the pelvic area were performed using 6 fresh, nonembalmed male cadavers. When the needle was positioned in the targeted muscle, 0.5 mL of green filler was injected. After the injection procedure, each specimen was dissected to evaluate the accuracy of US-guided injection into the intrapelvic portion of the OI. RESULTS: Twelve injections were made into the targeted muscles in the 6 cadaveric specimens. All injections placed filler into the OI muscles just medial to the inferior pubic ramus. There was no case in which a needle passed through unintended structures, such as neurovascular structures. CONCLUSIONS: The newly developed US-guided pararectal approach allowed accurate insertion of a needle into the intrapelvic portion of the OI. This US-guided method facilitated a more precise approach to the intrapelvic portion of the OI and may help differentiate conditions or symptoms caused by other structures.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00115550-201407000-00014&LSLINK=80&D=ovft
DOI
10.1097/AAP.0000000000000093
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
Rha, Dong Wook(나동욱) ORCID logo https://orcid.org/0000-0002-7153-4937
Lee, Sang Chul(이상철) ORCID logo https://orcid.org/0000-0002-6241-7392
Lee, Sang Hee(이상희)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99462
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