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

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.