Radiocarpal and first metatarsophalangeal intraarticular injection site confirmation with fluoroscopy and review of accuracy of intraarticular injections.

The aim of this study was to determine the accuracy of radiocarpal (RC) joint and first metatarsophalangeal (MTP) joint arthrocentesis using fluoroscopy. Rheumatologists were asked to mark their usual site of arthrocentesis over fluoroscopically identified joint lines of the right RC and right first MTP joints. Ten rheumatologists with a mean of 17.9 years of clinical experience participated. The sites marked were a mean of 0.85 cm (range, 0-1.6 cm; SD, 0.5 cm) and 0.33 cm (range, 0-1.3 cm; SD, 0.4 cm) from the fluoroscopically identified RC and MTP joints, respectively. Traditional palpation-guided joint aspiration may be inaccurate. Fluoroscopic guidance has the potential to improve accuracy of arthrocentesis of small joints.