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*Medical Disclaimer - All information provided on these web pages is intended for general information purposes only, and is provided with the understanding that neither Dennis Sagini, MD nor any of its employees are engaged in rendering surgical or medical advice or recommendations to those who read it. Further, use of this site does not establish a doctor-patient relationship between the user and Dennis Sagini, MD

 

This information should not be considered a substitute for evaluation by a board certified orthopedic surgeon to address individual medical or orthopedic needs. Individual facts and circumstances will determine the treatment that is most appropriate.

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Ultrasound Guided Hand Injections

October 22, 2014

What is an ultrasound guided hand injection?

 

 

Ultrasound guided joint injections are a minimally invasive treatment option.  They are used to relieve pain caused by inflammatory joint conditions, such as rheumatoid arthritis, synovitis (inflammation of the lining of the joint),  tendonitis, bursitis and gout.  Often, these conditions respond to corticosteroid and/or local anesthetic medication injected directly into the joint or the soft tissue next to the joint (bursa).  This reduces the inflammation and provides pain relief.  Joint injections can be used to relieve pain in any joint in the body, including:

 

  • Knee (knee joint, Baker's cyst) 

  • Shoulder (rotator cuff/subacromial bursa, acromioclavicular joint, shoulder/glenohumeral joint, biceps tendon) 

  • Ankle 

  • Elbow (lateral epicondyle, medial epicondyle, elbow joint) 

  • Wrist (thumb/first CMC joint , carpal tunnel, trigger finger, DeQuervain's tenosynovitis) 

  • Thumb 

  • Hip (hip joint, bursa/greater trochanter, piriformis, sacroiliac joint) 

  • Large toe 

  • Facet joints of the vertebrae

 

For the highest chance at success with this treatment, it is important to ensure the injection is administered to the precise place. For example, joint injections need to be administered within the joint space, and not the surrounding soft-tissues. Tendon injections should be administered in the tendon sheath, the structure that envelops the tendon, and not inside the tendon.

 

Traditionally, injections have been administered "blind." This doesn't mean the practitioner isn't looking, but rather that they cannot see the medication as it leaves the needle. Instead, your doctor relies on experience, location, and feel to know if the injection is being given in the correct spot.

 

Image Guided Injections  (Ultrasound Guided)

 

One way to try to increase the chance of getting the injection into the right spot is to use an imaging device to allow you to "see" inside the body as the injection is being given. The most commonly used device is an ultrasound machine.  Many orthopedic surgeons, and other doctors, are using an ultrasound to guide their injections and improve accuracy.

 

Ultrasound guided injections are administered in a similar way to traditional injections, using the same type of needle and syringe.  However, when an ultrasound is used, a small probe attached to a video monitor is pressed against the skin.  This is similar to the device used to see a fetus in a pregnant mother. The probe is placed next to the body part to be injected--commonly a joint or tendon sheath. Once your doctor has identified the anatomic landmarks, the injection is administered while watching the needle with the ultrasound. Ultrasound is an excellent way to visualize fluids. Therefore, an experienced physician can identify the fluid being injected, and ensure it is going precicely in the proper location.

 

 

For more information about ultrasound guided injections, or other procedures for treatment of conditions of the hands or upper extremities, call Dr. Sagini's office at (239) 337-2003.

 

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