The author responds-pain control in AC joint separation

We appreciate the letter in regards to our recent publication on a strategy for pain control for patients with acute acromioclavicular (AC) joint separation. First, we agree that the in-plane technique allows for clear needle tip visualization, but this may not be possible in most patients with an AC separation. The distance from skin surface to AC joint is often less the 1-2 cm and there is very little surrounding tissue to perform a visualized in-plane technique. We have used the out-of-plane technique safely on numerous occasions for AC separations as well as other ultrasound-guided procedures (posterior tibial nerve block, ankle arthrocentesis, etc.), and feel that when the target of the procedure is shallow, the in-plane technique can be more difficult.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research