Ultrasound‐guided versus Nonguided Tibiotalar Joint and Sinus Tarsi Injections: A Cadaveric Study
- 27 April 2010
- Vol. 2 (4), 277-281
- https://doi.org/10.1016/j.pmrj.2010.03.013
Abstract
To compare the relative accuracy rates of ultrasound (US)-guided versus nonguided ankle (tibiotalar) joint and sinus tarsi injections in a cadaveric model. Prospective human cadaveric study with injection technique randomized and accuracy assessed by skilled observers blinded to injection technique. Procedural skills laboratory in a tertiary care academic medical center. Twelve embalmed and 8 unembalmed cadavers (40 ankles) were used for this investigation. Using a predetermined randomization process, 1 ankle of each cadaver was injected with US guidance and the other without. Tibiotalar joint injections were performed via an anterior approach and sinus tarsi injections performed via an anterolateral approach. All injections were performed by the senior author using a 22-gauge, 1.5-inch needle to place 3 mL of 50% diluted blue latex solution into the target area. Two anatomists blinded to the injection technique dissected each ankle and determined injection accuracy based on previously agreed upon criteria. Injection accuracy, where an accurate injection delivered injectate within the tibiotalar joint or into the mid-portion of the sinus tarsi. The accuracy rate for US-guided tibiotalar joint injections was 100% (20/20) versus 85% (17/20) for nonguided injections. The accuracy rate for US-guided sinus tarsi injections was 90% (18/20) versus 35% (7/20) for nonguided injections. In this cadaveric study, US guidance produced superior accuracy compared with nonguided injections with respect to both the tibiotalar joint and sinus tarsi. Although further research is warranted, clinicians should consider US guidance to optimize injectate placement into these areas when optimal accuracy is necessary for diagnostic or therapeutic purposes.Keywords
Funding Information
- Mayo Clinic Department of PM&R
This publication has 24 references indexed in Scilit:
- Accuracy of intra-articular injections in peripheral joints performed blindly in patients with rheumatoid arthritisRheumatology, 2008
- Ultrasound-Guided Piriformis Injection: Technique Description and VerificationArchives Of Physical Medicine and Rehabilitation, 2006
- Ultrasound guidance allows accurate needle placement and aspiration from small joints in patients with early inflammatory arthritisRheumatology, 2003
- Ultrasound-guided Interventions in the Foot and AnkleSeminars in Musculoskeletal Radiology, 2002
- Guidance by ultrasound of intra-articular injections in the knee and hip jointsOsteoarthritis and Cartilage, 2001
- Intra-articular glucocorticoid treatment of the rheumatoid wrist. An ultrasonographic studyScandinavian Journal of Rheumatology, 2001
- Diagnostic injections of the hindfoot joints in patients with rheumatoid arthritis prior to surgical fusionThe Foot, 1999
- Localization of specific joint causing hindfoot pain: value of injecting local anesthetics into individual joints during arthrography.American Journal of Roentgenology, 1995
- Technical report: Ultrasound guidance for injection of soft tissue lesions around the heel in chronic inflammatory arthritisClinical Radiology, 1995
- Importance of placement of intra-articular steroid injections.BMJ, 1993