Use of ultrasound in needle placement in intercostal muscles: A method for increased accuracy in cadavers

Michele Retrouvey, Tony Chiodo, Anton Quidley-Nevares, Jonathan Strand, Craig Goodmurphy

Research output: Contribution to journalArticlepeer-review


Objective: To validate the use of ultrasound technology for the positioning and leveling of intercostal needle placement. Design: Double-blinded experimental study. Setting: An anatomy laboratory. Participants: Two board-certified physical medicine and rehabilitation physicians, 2 first-year medical students, 1 anatomist, and 8 cadavers. Interventions: Four unfixed cadavers were used for unguided needle placement, and 3 unfixed and 1 partially fixed cadavers were used for ultrasound-guided needle placement. Ultrasound-guided needle placement was then confirmed with computed tomography and blind dissection. Main Outcome Measure: The accuracy of needle placement. Results: The unguided study showed needle placement in an intercostal muscle 89% of the time, but in only 15.4% of the time was the correct level sampled. In the 96 needle placements completed, the unguided needle placements had an accuracy of 8.3%, while ultrasound-guided needle placements had an accuracy of 93% (χ2 with P<.005). Conclusions: Ultrasound guidance dramatically increases needle placement accuracy for intercostal nerve blocks and intercostal muscle sampling for electromyography.

Original languageEnglish (US)
Pages (from-to)1256-1259
Number of pages4
JournalArchives of Physical Medicine and Rehabilitation
Issue number7
StatePublished - Jul 2013

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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