Skip Navigation


Rheumatology Advance Access originally published online on July 25, 2008
Rheumatology 2008 47(10):1503-1505; doi:10.1093/rheumatology/ken295
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
47/10/1503    most recent
ken295v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Pichler, W.
Right arrow Articles by Weinberg, A. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pichler, W.
Right arrow Articles by Weinberg, A. M.
Related Collections
Right arrow Education
Right arrow Rheumatoid Arthritis
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Frequency of successful intra-articular puncture of finger joints: influence of puncture position and physician experience

W. Pichler1, W. Grechenig1, S. Grechenig1, F. Anderhuber2, H. Clement1 and A. M. Weinberg3

1Department of Traumatology, 2Department of Anatomy and 3Department of Paediatric Surgery, Medical University of Graz, Graz, Austria.

Correspondence to: W. Pichler, Department of Traumatology, Medical University of Graz (MUG), Auenbruggerplatz 7a, A - 8036 Graz, Austria. E-mail: wolfgang.pichler{at}klinikum-graz.at


  Abstract

Objective. Physicians and specialists routinely perform IA punctures and injections on patients with joint injuries, chronic arthritis and arthrosis to release joint effusion or to inject drugs. The purpose of this study was to investigate the frequencies of intra- and peri-articular cannula positioning during this procedure.

Methods. A total of 300 cadaveric finger joints were injected with a methyl blue-containing solution and subsequently dissected to distinguish intra- from peri-articular injections. To assess the influence of puncture position on successful injection, half of the joints were injected dorsally and the other half dorso-radially. To assess the importance of practical experience for a positive outcome, half of the injections were performed by an inexperienced resident and half by a skilled specialist.

Results. The overall frequency of occurrence of peri-articular injections was much higher than expected (overall: 23%, specialist: 15%, resident: 32%) The failure rate was significantly higher than the average with the joints of the little finger and the DIP joints of each phalanx.

Conclusions. Even skilled specialists cannot guarantee to insert the cannula into the joint in every case. Unintended peri-articular drug injection moreover may affect the surrounding ligaments or tendons, leading to serious complications. Correct positioning of the needle in the joint may be facilitated by fluoroscopy in doubtful cases.

KEY WORDS: Intra-articular injection, Joint puncture, Finger joint

Submitted 24 January 2008; revised version accepted 26 June 2008.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.