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Treatments & Injections

Accuracy of Ultrasound Guided Injections

Accuracy of ultrasound-guided injections introduction Injections of various compounds are designed to reduce inflammation, possibly slow the increasing degeneration of the joint, and decrease pain.

A
Andrew Schleihauf
Sports Medicine Physician Β· October 6, 2024 Β· 3 min read

Overview

Accuracy of ultrasound-guided injections introduction Injections of various compounds are designed to reduce inflammation, possibly slow the increasing degeneration of the joint, and decrease pain. In sports medicine and orthopedics, commonly injected agents include corticosteroids, hyaluronic acid, PRP and possibly other biologic agents. It is essential for these compounds to directly enter the intra-articular joint to achieve maximum efficacy.

Symptoms

Complications can arise from misplaced injections that include pain or swelling at the site of injection, inflammation of the synovium or even septic arthritis. The most studied joint in regards to comparing the accuracy of image guided versus palpation guided injections is the knee joint. There are many different techniques for injecting the knee, with the most common being an anatomical-based approach.

Causes and Risk Factors

This method uses various visualized and palpated anatomical landmarks. For example, with the superolateral injection technique, the patient is positioned supine with legs extended. The physician then palpates the patella and inserts the needle on the superolateral surface of the patella, aimed toward the center of the patella and directed slightly posteriorly and inferomedially into the knee joint.

Treatment Options

This technique is widely used but there are some that use the medial or lateral approach inferior to the patella. There is no β€œbest” or consensus when it comes to anatomical based or palpation guided injections for the knee. To identify the correct trajectory and depth for needle placement, physicians also can elect to use other methods to confirm needle placement, including fluoroscopy, air arthrogram, backflow technique, and ultrasound devices.

Recovery

In the past two decades, the use of ultrasound has expanded significantly in musculoskeletal medicine and many providers now use image guidance in hopes to improve accuracy. Found that the accuracy rate of image-guided injections was more accurate compared with blinded injections with accuracy above 95 percent. When comparing blinded injections, they reported that injections through the superolateral patellar as being the most accurate, and that about 1 in 5 blinded injections into the knee were inaccurate.

When to See a Doctor

If you are experiencing symptoms that may be related to accuracy of ultrasound guided injections, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

Treatments & InjectionsInjections
A
Andrew Schleihauf
Sports Medicine Physician
Sports Medicine Review contributor

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