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Purpose: Our purpose is to evaluate the clinical efficacy of ultrasound-guided interscalene blocks in patients with neurogenic thoracic outlet syndrome (TOS). Materials: An IRB-approved retrospective, single-institution, interdepartmental study was performed on all patients with neurogenic thoracic outlet syndrome (NTOS) who underwent USguided interscalene blocks between 11/25/14 and 12/31/17. All clinical diagnoses and evaluation were performed by a single board certified neurosurgeon who specializes in NTOS. All blocks were performed by subspecialty radiologists in the section of musculoskeletal radiology using local anesthetic and steroids. Queried data included age, gender, presenting symptoms, prior interventions, physical exam findings, initial electromyogram (EMG) findings, effect of the block, and post-block surgical outcomes. Data analysis was performed using Chi-square and T tests. Results: A total of 87 consecutive blocks were performed during this 3-year period. Mean patient age was 39 years old. Technical success was achieved in 100% of patients and without complications. 82% of blocks performed (n¼71) had post-block followup with the neurosurgeon. 63% (n¼45) of blocks performed resulted in relief. 11% (n¼8) experienced transient worsening of symptoms with eventual return to baseline. Blocks performed on patients without a history of trauma or shoulder/neck surgery were more likely to receive benefit from the block (71% vs 38%, p ¼ 0.014) and those who had a history of surgery/trauma were more likely to develop transient worsening (25% vs 7%, p¼ .024). Normal findings on brachial plexus ultrasound were also associated with pain relief from the block versus those with abnormal findings (70% vs 44%, p¼.027). No association between block outcome and gender, EMG findings, or postsurgical relief was noted. Conclusions: Neurogenic TOS is an extremely debilitating disease that can persist despite surgical efforts. Our study demonstrates that an US-guided interscalene block is technically feasible, safe, and has the potential to provide symptomatic relief in select patients, namely those without history of shoulder/neck trauma and surgery. Further investigation is encouraged.Purpose: To examine the efficacy of image-guided percutaneous interventions in pain and local tumor control in the treatment of osseous metastases from breast cancer. Materials: This is an IRB-approved retrospective study of 26 patients (mean age 54.9, SD 12.5) with 51 osseous metastases

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