Table 2.

Pearls and Pitfalls

When in doubt, use more ultrasound gel. Too much gel may make a mess, but too little can limit image quality.

Know your limits. If you are not 100% confident in your ability to reach the piriformis due to body habitus, do not proceed.

The transducer should not be pressed into the soft tissues with force. It should sit securely on top of the skin. Downward force can cause compression of the soft tissues and vascular structures, obscuring visibility.

The transducer should be held firmly with the fingers around the probe and on the patient's skin. This will prevent the transducer from moving during the procedure, causing loss of visibility.

Always check for vascular structures before moving forward with an injection to prevent damage to the vessels and bleeding.

Locate the sciatic nerve and maintain visualization throughout the injection to prevent contact with the needle.

Optimize the ultrasound image prior to moving forward with an injection using appropriate depth, focal zone, and gain.