Authors (including presenting author) :
TONG KK (1), TONG CKS (2), MAK YK (3), CHAN TW (3)
Affiliation :
(1) Department of Clinical Oncology, (2) Department of Medical Physics, (3) Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital
Keyword 3: :
simulation training
Keyword 6: :
ultrasound-visible
Introduction :
Bursitis is the painful inflammation or swelling of bursa, a small fluid-filled sac that cushions joints like shoulder. When bursitis occurs, patients would often experience sharp and aching pain, especially with overhead activities. Injection of corticosteroid and a numbing agent into the joint or bursa is a minimally invasive procedure to reduce pain and inflammation.When performing corticosteroid shoulder injection, doctors are often using ultrasound guidance for precision. It is however reported that bursal placement was achieved in only 60-70% of initial attempts by novice operators, and the accuracy improves after 30-50 supervised procedures. This highlights the significance of training with shoulder phantoms.
Objectives :
Current commercially available phantoms are often associated with high-cost, limited lifespan, and inability to simulate variable pathological conditions. This project therefore aims to develop an affordable, ultrasound-visible 3D-printed shoulder phantom with modular pathology simulation and real-time feedback mechanisms to significantly enhance procedural training efficacy, safety, and skill retention.
Methodology :
The 3D-printed phantom was based on the anatomy of real patient with reference to MRI image sets. It consisted of scapula, clavicle and humerus, which were printed with polylactic acid. Skin, muscles and the respective tendons (i.e subscapularis, supraspinatus and deltoid) were made of silicone. In order to replicate the texture of muscles and tendons while ensuring long-term durability, silicone formulations were optimized with additives for enhanced puncture resistance and self-sealing properties. Bursa was designed as a replaceable modular cartridge, allowing simulation of different degrees of bursitis (e.g., varying fluid volume, thickening or calcification) by swapping pre-fabricated inserts.
Result & Outcome :
A life-size, low cost, anthropomorphic shoulder phantom was constructed. It replicated anatomical features of muscles and bony landmarks. Accuracy of needle insertion could also be reviewed by removing the top cover of phantom. As the model highly simulated the sensation of human skin, muscles and tendon, and provided immediate subjective feedback on injection accuracy, it enabled trainees to engage in high-quality practice with unlimited repetitions under ultrasound guidance, leading to faster skill acquisition and improved patient safety in clinical practice. The constructed phantom has been tested by orthopedic surgeons and prepared for the coming training courses in 2026.
