Sonographically guided caudal epidural steroid injections.
OBJECTIVE
Caudal epidural steroid injections are used for the symptomatic treatment of radicular lumbosacral pain syndromes, but incorrect injection placement has been recognized as a common problem with the routinely used unguided technique. We aimed to explore the use of sonography to facilitate this procedure.


METHODS
In patients with clinically unreliable anatomic landmarks, high-resolution real-time sonography was used to identify those landmarks and to assist in correct needle placement.


RESULTS
Sonography enabled localization of the sacral hiatus landmarks. We found this method particularly useful for guiding needle placement in patients with moderate obesity.


CONCLUSIONS
Real-time sonography can facilitate caudal epidural steroid injections.
Klocke
Rainer
R
Royal National Hospital for Rheumatic Diseases, Bath, England. rainer.klocke@rnhrd-tr.swest.nhs.uk
Jenkinson
Timothy
T
Glew
David
D
D000368:Aged; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D008875:Middle Aged; D012585:Sciatica / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D013256:Steroids