A slight medial to lateral approach helps with getting intraarticular in most patients as well. The ilium is superficial to the sacrum, so this needle trajectory helps slide under it and into the joint.
Technically, they are usually pretty easy. Scottie dog view or AP (I tend to find the oblique a little easier to see the lucency), touch down on os with a 25G quinke with a small bend in it and walk it in a mm or two. You can put a smudge of contrast there if you want. Then inject.
I know people who did USU/HPSP who are in financial ruin and those who are civilian primary care docs who have well-eclipsed my own savings. The ability to save, invest, and manage debt is an individual merit and not related to mil vs civ.
For those wondering, Tricare won't even credential you while on terminal leave. I thought I'd try and get it done early, but they told us to resubmit after my ETS date.
There's a reason everyone congratulates you on your way out and not on the way in. I felt like a prisoner released for good behavior getting high fives from all the guards during my out-processing.
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