High-frequency ultrasound guidance for neurotoxin injections

In the last decade, advances in ultrasound technology, specifically the development of high-frequency linear transducers, have made ultrasound an indispensable tool for imaging the musculoskeletal system. Using ultrasound to identify target structures for botulinum neurotoxin injection is a natural extension of the applications of musculoskeletal ultrasound. The goals of incorporating ultrasound with neurotoxin injections are to improve the accuracy of needle placement, avoid undesired structures, minimize volume overload during injection, and reduce the risk of the procedure. This article provides an update on the neurotoxins and their expanded use in clinical practice, and a detailed review of the use of ultrasound for the varied indications and applications for neurotoxin injection.