PMC8008197_01
Longitudinal (A) and axial (B) ultrasound image showing the dorsal scapular nerve (DSN), dorsal scapular artery (DSA), and adjacent muscles
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fig1
The patient subsequently had a high-resolution ultrasound scan on Siemens Acuson NX3 Elite Ultrasound Machine using 5-16 linear probe, which demonstrated significant thickening of the dorsal scapular nerve at the level of the belly of the rhomboid major muscle, with narrowing and flattening distally (Fig. 1).
Longitudinal ultrasound image showing the needle (arrow) with tip (A) adjacent to DSN and injectate adjacent to the DSN (B)
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PMC8008197_01_jou-21-84-e74-g002.jpg
fig2
Once the nerve was identified and the site of entrapment was visualised, the needle trajectory used was planned medially to laterally in the plane along the long axis of the probe and using a 22 G spinal needle hydrodissection with a total of 12 ml of injectate (4 ml of 1% lignocaine + 7 ml of 5% dextrose and 1 ml of injection triamcinolone (40 mg) (Fig. 2).