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Ultrasound Verification Of Safe Needle Examination Of The Rhomboid Major Muscle
Author(s) -
Cushman Daniel,
Henrie Michael,
Ver Scholl Linda,
Ludlow Monica,
Teramoto Masaru
Publication year - 2018
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25642
Subject(s) - palpation , rib cage , medicine , rhomboid , pneumothorax , torso , electromyography , ultrasound , anatomy , physical examination , ultrasonography , radiology , physical medicine and rehabilitation , biochemistry , chemistry , enzyme , proteases
: Palpation of a thoracic rib is a common method for reducing the risk of pneumothorax during electromyographic examination of the rhomboid major muscle, but its accuracy is unknown. Methods : Two physicians palpated healthy subjects to attempt to identify the center of a rib located beneath the rhomboid major muscle. The identified location was examined with ultrasonography to examine its accuracy and the subject's anatomical depths. Results : Forty‐four subjects (88 ribs) were studied. Palpation demonstrated a 66.3% accuracy rate, with significantly more incorrect palpations seen with greater muscle thickness ( P = 0.004) and body mass index ( P = 0.037), but not adipose thickness, age, or skin thickness ( P > 0.05). Discussion : Palpation of the ribs in an attempt to avoid inadvertent pneumothorax while examining the rhomboid major may be inaccurate, primarily in patients with large muscle bulk. We suggest a brief ultrasound evaluation before electromyography to gauge correct needle depth. Muscle Nerve 57 : 61–64, 2018