The Elias University Hospital Approach: A Visual Guide to Ultrasound-Guided Botulinum Toxin Injection in Spasticity: Part II—Proximal Upper Limb Muscles

• Published in: Toxins Vol. 17; no. 6; p. 276
• Main Authors: Popescu, Marius Nicolae, Căpeț, Claudiu, Beiu, Cristina, Berteanu, Mihai
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 31.05.2025; MDPI
• Subjects: Botulinum toxin; Botulinum toxin type A; botulinum toxin-A injections; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - therapeutic use; Care and treatment; Clinical medicine; Diseases; Dosage and administration; Drug therapy; Hospitals; Hospitals, University; Humans; Image quality; Injection; Injections, Intramuscular; Limbs; Morphology; Muscle Spasticity - diagnostic imaging; Muscle Spasticity - drug therapy; Muscle Spasticity - physiopathology; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - drug effects; Muscles; musculoskeletal ultrasound; Neuromuscular Agents - administration & dosage; Physiological aspects; post-stroke spasticity; proximal upper limb muscles; Review; Spasticity; Toxins; Ultrasonic imaging; Ultrasonic waves; Ultrasonography, Interventional; Ultrasound; ultrasound-guided therapy; Upper Extremity - diagnostic imaging; Romania; United States > US; ultrasound-guided therapy; musculoskeletal ultrasound; proximal upper limb muscles; botulinum toxin-A injections; post-stroke spasticity
• ISSN: 2072-6651; 2072-6651
• DOI: 10.3390/toxins17060276

Ultrasound-guided botulinum toxin type A (BoNT-A) injections play a critical role in the management of upper limb spasticity. This is the second part of ‘The Elias University Hospital Approach: A Visual Guide to Ultrasound-Guided Botulinum Toxin Injection in Spasticity’ and it focuses on the proximal upper limb muscles, complementing the first part, which addressed the distal upper limb muscles. This guide provides a detailed analysis of ultrasound anatomy, clinical relevance, and injection strategies for the latissimus dorsi, teres major, subscapularis, pectoralis major, pectoralis minor, deltoid, triceps brachii, biceps brachii, brachialis, and brachioradialis. Using the Elias University Hospital (EUH) model, it presents a structured approach to BoNT-A administration, ensuring precision, safety, and optimal outcomes in spasticity management. To enhance clinical application, this guide incorporates a wide array of high-quality ultrasound images and dynamic videos, offering a comprehensive and practical understanding of scanning techniques, anatomical structures, and injection procedures. This second part of the series serves as an essential reference for clinicians, aligning with the first installment to provide a complete and systematic approach to ultrasound-guided BoNT-A therapy for upper limb spasticity.