Ultrasound for the determination of appropriate needle length for intragluteal injection of long-acting rilpivirine-cabotegravir.
Candice Gueuning, Mrishta Brizmohun, Nicolas Dauby et al.
✦ AI-curated · Sources linked
Case in brief
Two patients on long-acting cabotegravir and rilpivirine experienced virological rebound. The first, an obese individual, had ultrasound findings of significant subcutaneous adipose tissue and injection granulomas, indicating improper injection technique. After adjusting the needle length based on ultrasound guidance, virological suppression was successfully restored. The second patient, with a normal BMI, also showed subcutaneous granulomas and thick adipose tissue, highlighting similar injection issues.
Diagnostic / clinical pearl
Ultrasound can effectively assess subcutaneous adipose tissue thickness and injection technique, aiding in the selection of appropriate needle length for intramuscular injections, particularly in patients with elevated BMI.
Why it matters
This case underscores the importance of incorporating imaging techniques like ultrasound in managing treatment failures related to long-acting injectable therapies, potentially improving patient outcomes.