Ultrasound-guided intra-articular injection of the trapeziometacarpal joint: description of technique

Gregory L Umphrey, Jeff S Brault, Mark-Friedrich B Hurdle, Jay Smith
Archives of Physical Medicine and Rehabilitation 2008, 89 (1): 153-6

OBJECTIVE: To describe a new technique to perform an ultrasound-guided intra-articular injection of the trapeziometacarpal (TMC) joint.

DESIGN: Ultrasound-guided injection of the TMC joint was completed on fresh frozen cadaver hand specimens using diatriazoate meglumine contrast. A fluoroscopic posteroanterior image of the TMC joint was then obtained to verify intra-articular placement of the contrast.

SETTING: Anatomy lab in a medical college.

SPECIMENS: Seventeen fresh frozen cadaver hand specimens.

INTERVENTIONS: Not applicable.

MAIN OUTCOMES MEASURE: Verification of this technique was confirmed using fluoroscopy and contrast.

RESULTS: Sixteen (94%) of 17 joints injected showed contrast material within the TMC joint with a single cutaneous puncture. One intra-articular injection was initially misplaced into the scaphotrapeziotrapezoid joint.

CONCLUSIONS: Ultrasound may be used to accurately perform intra-articular TMC injections. Ultrasound provides a viable alternative to fluoroscopy when accurate injection into the TMC joint is required for diagnostic or therapeutic purposes.

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