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Ultrasound guided injection of the subtalar joint

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Oct 27, 2009.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Accuracy of sonographically guided posterior subtalar joint injections: comparison of 3 techniques.
    Smith J, Finnoff JT, Henning PT, Turner NS.
    J Ultrasound Med. 2009 Nov;28(11):1549-57.
  2. facfsfapwca

    facfsfapwca Active Member

    A second study should be done showing accuracy without Ultra sound.
  3. Mart

    Mart Well-Known Member

    Already done albeit with slightly different methodolgy.



    The St. James Foot Clinic
    1749 Portage Ave.
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918

    Accuracy of posterior subtalar joint injection without fluoroscopy
    Kirk, K.L.a , Campbell, J.T.b , Guyton, G.P.a , Schon, L.C.a
    a Department of Orthopaedic Surgery, Union Memorial Hospital, 3333 N Calvert Street, Baltimore, MD 21218, United States
    b Institute for Foot and Ankle Reconstruction at Mercy, Mercy Medical Center, Baltimore, MD, United States

    Injection into the posterior subtalar joint has not been validated for accuracy using radiographic end points. We asked whether needle placement into a normal posterior subtalar joint could be performed accurately and selectively by experienced surgeons without fluoroscopic guidance. Three fellowship-trained orthopaedic foot and ankle surgeons each injected the posterior subtalar joint of 20 cadaveric specimens using an anterolateral approach. Fluoroscopic images were obtained by an independent investigator and blinded. A separate fellowship-trained foot and ankle surgeon interpreted the images. Of 60 injections, 58 were accurate and two were extraarticular based on interpretation by an independent foot and ankle surgeon. Extravasation into the ankle occurred in 14 samples and into the peroneal sheath in two samples. Experienced surgeons can place intraarticular injections into a radiographically normal posterior subtalar joint without fluoroscopy with a high degree of accuracy. However, extravasation into the ankle or peroneal tendon sheath occurred in an unpredictable fashion, suggesting selectivity of injection placement is relatively limited without the use of fluoroscopy. Fluoroscopy may not be necessary for injections used solely for therapeutic purposes. However, if the injection is intended for diagnostic purposes or to assist in surgical decision-making or if the joint is abnormal, we recommend fluoroscopy to ensure the subtalar joint is the only anatomic structure impacted by the injection. © 2008 The Association of Bone and Joint Surgeons.

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