The Class of 2017’s Abrahm Behnam has married his design skills with medical knowledge to produce 68 illustrations in the recently released text Ultrasound-Guided Chemodenervation and Neurolysis: Reference Manual and DVD Procedure Atlas.
Abrahm Behnam, Class of 2017
Before entering medical school, Abrahm was a biomechanics research engineer at the National Institutes of Health. “I spent off-hours shadowing the medical director of my section during her clinical rounds.”
His director, Katharine Alter, M.D., is a pioneer in using ultrasound to guide chemodenervation procedures. Chemodenervation uses neurotoxins to paralyze a muscle or group of muscles to treat patients with hypertonia, movement disorders and a variety of other conditions. Alter had a medical teaching atlas underway to introduce the procedures for clinicians, and Abrahm offered his help in capturing basic patient photography and videos to illustrate the concepts.
As Abrahm began the project, he learned that three types of images would be featured: clinical, anatomical and ultrasound. All related to one another but demonstrated different perspectives on the procedure. Abrahm suggested it would be helpful to combine the images to highlight the anatomical obstacles involved with deep injections. The authors welcomed his suggestion and devoted a 70-page chapter to his illustrations.
Abrahm’s illustration of an ultrasound-guided injection in the neck is featured on the text’s cover.
Used with permission: Alter, K.A., Hallett, M., Karp, B., & Lungu, C. (2012). Ultrasound-Guided Chemodenervation and Neurolysis: Reference Manual and DVD Procedure Atlas. New York, NY: Demos Medical Publishing, LLC.
“The combined image includes a clinical photograph with anatomical illustrations superimposed specific to the photograph’s perspective and to bony landmarks of the patient’s anatomy,” Abrahm explains. “Each photo-illustration has a series of anatomical illustration layers that can be peeled off layer-by-layer to view deeper anatomy.”
Abrahm’s chapter, Muscle Layers and Injection Points Atlas, provides detailed pictorial reference of eight areas of the body from the side of the face to the lower leg. The illustrations guide clinicians in planning and performing chemodenervation procedures by showing the relationship and orientation of individual muscles and surface anatomy to help identify optimal injection sites. Clinicians can interactively scroll through muscle layers using an accompanying DVD featuring 68 animations that the editors have described as a stunning visual roadmap.
“When planning chemodenervation procedures many practitioners find visualizing complex 3 D musculoskeletal anatomy challenging,” said Alter, who is medical director of the Functional and Applied Biomechanics Section of the Rehabilitation Medicine Department at the NIH. “Abrahm’s images provide clinicians with a user friendly pictorial reference guide of the relevant musculoskeletal anatomy. It reveals details about the orientation of and overlapping nature of target muscles. In the short time that the text has been in print we have received a lot of positive feedback about this section of the atlas from clinicians.”
As a self-taught graphic designer, Abrahm’s previous experience was limited to creating logos and t-shirts for various clubs and societies. He now hopes to keep his newly discovered skill alive by working on more medical illustration projects.