Ultrasound guidance for epidural steroid injections

Ultrasound (US) guidance is practiced widely in regional anesthesia. It is becoming increasingly used for pain medicine interventions. US-guided neuraxial analgesia has also been demonstrated despite many technical challenges. The applicability of US guidance for neuraxial steroid injections adds the dimension of complications secondary to particulate steroids. This review will discuss the available evidence for the use of US in neuraxial analgesia and for epidural steroid injections (ESIs), the technique and limitations, and the potential uses of US for ESIs.