Ultrasound versus palpation guidance for intra‐articular injections in patients with degenerative osteoarthritis of the elbow

Kim, Tai Kon; Lee, Ji Hae; Park, Ki Deok; Lee, Sang Chul; Ahn, Jaeki; Park, Yongbum

doi:10.1002/jcu.22071

Cited by 30 publications

(12 citation statements)

References 24 publications

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“…Intra-articular contrast agent injection prior to CT-arthrography should always be performed with an imaging-guided technique rather than a palpation-guided technique, since it results in more accurate intra-articular delivery, as confirmed by Kim et al [ 38 ].…”

Section: The Role Of Ct-arthrographymentioning

confidence: 99%

Overuse-related instability of the elbow: the role of CT-arthrography

et al. 2021

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The elbow is a complex joint whose biomechanical function is granted by the interplay and synergy of various anatomical structures. Articular stability is achieved by both static and dynamic constraints, which consist of osseous as well as soft-tissue components. Injuries determining instability frequently involve several of these structures. Therefore, accurate knowledge of regional anatomy and imaging findings is fundamental for a precise diagnosis and an appropriate clinical management of elbow instability. This review focuses particularly on the varied appearance of overuse-related elbow injuries at CT-arthrography.

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Section: The Role Of Ct-arthrographymentioning

confidence: 99%

Overuse-related instability of the elbow: the role of CT-arthrography

et al. 2021

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“…Despite the successful results of non-image-guided intra-articular hip injections in several studies described above, previous studies have demonstrated significantly improved accuracy, pain, and/or functional outcomes for image-guided versus palpation-guided injections of the knee joint [ 2 ], acromioclavicular joint [ 22 , 23 ], distal radioulnar joint [ 24 ], elbow joint [ 25 ], subacromial space [ 26 ], and the peroneal tendon sheath [ 27 ]. However, as mentioned above, image-guided injections come with an increased cost to patients and time lost between presentation and established diagnosis, two important parameters that the current technique aims to address.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a non-image-guided diagnostic hip injection in patients with clinical and radiographic evidence of intra-articular hip pathology

Kraeutler

Garabekyan

Fioravanti

et al. 2018

Journal of Hip Preservation Surgery

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The purpose of this study was to determine the likelihood of pain relief, as a measure of accurate diagnosis of intra-articular hip pathology and correct needle placement, with a non-image-guided intra-articular hip injection performed bedside in the clinic. A retrospective study of prospectively collected data was performed in a consecutive cohort of patients diagnosed with symptomatic intra-articular hip pathology who underwent a non-image-guided intra-articular injection in the clinic. All patients had clinical and radiographic evidence of hip impingement, hip instability, chondrolabral pathology, or other causes of intra-articular hip pain. A previously described technique for a non-image-guided hip injection was performed using 7–10 ml of 1% lidocaine for diagnostic evaluation with some patients receiving 2 ml of Kenalog®-40 if clinically indicated. Ten minutes following each injection, the patient was asked to report the percent improvement in pain (from 0 to 100%) while physical examination and provocative tests were repeated. The final study cohort comprised 142 patients (161 injections). In three cases, patients were either unable to assess or quantify any change in pain level 10 min following the injection. In the remaining 158 hip injections, pain relief was noted in 156 cases (156/158, 98.7%), with at least 70% improvement in pain level noted in 152 cases (152/158, 96.2%). Average pain relief among all 158 injections was 89 ± 16%. A non-image-guided diagnostic intra-articular hip injection yields reliable short-term pain relief, simultaneously endorsing accurate diagnosis of hip pathology and intra-articular needle placement.

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“…( 5 ) and Kim et al . ( 6 ) reported higher accuracy rates for the US-guided (91% and 100%, respectively) versus landmark-guided (64% and 77.5%, respectively) injection approaches.…”

Section: Elbowmentioning

confidence: 98%

Ultrasound-guided musculoskeletal interventional procedures around the elbow, hand and wrist excluding carpal tunnel procedures

et al. 2021

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Ultrasound is a fast, reliable and radiation-free method for the assessment of a wide range of pathological conditions, as well as for the guidance of percutaneous interventional procedures around the elbow, hand and wrist. Intraarticular and periarticular interventional procedures can be easily performed under continuous ultrasound monitoring to ensure correct needle positioning and medication delivery to a specific target. The most common ultrasound-guided procedures performed around the elbow, wrist, and hand are described in this review, excluding carpal tunnel procedures. Specifically, elbow steroid injections are performed in patients with inflammatory disorders, while hyaluronic acid can be administered in case of osteoarthritis. Septic olecranon bursitis requires percutaneous drainage for diagnosis and appropriate treatment. Dry needling and injection of regenerative medications, such as blood derivatives, are among the treatment options for lateral epicondylosis. Steroid injections are performed to give symptom relief in patients with ulnar neuropathy at the elbow. Hand and wrist steroid injections are performed in case of osteoarthritis, subsequently followed by hyaluronic acid injections, and in inflammatory disorders. Wrist ganglia can be safely aspirated and injected with steroids under ultrasound guidance. De Quervain’s tenosynovitis and trigger finger are chronic tenosynovitides of the wrist and digits, respectively, which can be treated with steroid injections, subsequently followed by hyaluronic acid injections. In conclusion, proper knowledge of the musculoskeletal disorders around the elbow, hand and wrist, as well as US-guided treatment options and operator training, are prerequisites to achieve good outcomes.

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Ultrasound versus palpation guidance for intra‐articular injections in patients with degenerative osteoarthritis of the elbow

Abstract: US-guided IA elbow injections by posterior approach may raise the accuracy rate in elbow joint injections.

Cited by 30 publications

References 24 publications

Overuse-related instability of the elbow: the role of CT-arthrography

Overuse-related instability of the elbow: the role of CT-arthrography

Efficacy of a non-image-guided diagnostic hip injection in patients with clinical and radiographic evidence of intra-articular hip pathology

Ultrasound-guided musculoskeletal interventional procedures around the elbow, hand and wrist excluding carpal tunnel procedures

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