New Simplified Approach to Real-Time Ultrasound-Guided Musculoskeletal and Peripheral Nerve Injections under Non-Draping, Non-Sterile Glove-Wearing Conditions

Ultrasound-guided musculoskeletal and peripheral nerve block injections are safe and cost-effective procedures that have gained popularity in pain medicine and family practice alike. The traditional injection process includes the use of sterile draping, sterile covering of transducer, and sterile glove wearing which significantly limits its efficiency and efficacy. From June 11, 2014 to January 30, 2025, our senior author, DG, has performed 33,509 musculoskeletal and joint injections, as well as peripheral nerve hydrodissections and block injections using a novel real-time ultrasound-guided musculoskeletal and peripheral nerve injection approach. This approach is employed under a non-draping, non-sterile transducer covering, non-sterile glove use condition, relying solely on betadine or chlorhexidine for skin antisepsis. Skin antisepsis being the most critical measure in preventing infections. This new approach significantly reduces the average procedure duration and maintains at least an equivalent post-procedure infection rate when compared to traditional sterile technique. Data from these procedures were collected from retrospective medical records and of the procedures performed, there have been 0 post-procedure infections. The aim of this article is to propose a simplified, real-time ultrasound-guided musculoskeletal and peripheral nerve injection approach under non-draping, non-sterile transducer covering, and non-sterile glove wearing conditions that maintains or improves upon the estimated incidence of post-procedure musculoskeletal infections using the traditional method. This new method that is supported by a sufficiently large patient set, significantly decreases procedure time and increases patient satisfaction.