Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 1 , Pages 153-156, January 2008

Ultrasound-Guided Intra-Articular Injection of the Trapeziometacarpal Joint: Description of Technique

Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN.

Abstract 

Umphrey GL, Brault JS, Hurdle M-FB, Smith J. Ultrasound-guided intra-articular injection of the trapeziometacarpal joint: description of technique.

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.

Key Words: Arthritis, Carpometacarpal joints, Injections, Rehabilitation, Ultrasonography, Wrist

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01595-X

doi:10.1016/j.apmr.2007.07.048

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 1 , Pages 153-156, January 2008