Feasibility of sonography for intra-articular injections in the knee through a medial patellar portal

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Authors: Sang Hee Im ; Sang Chul Lee ; Yong Bum Park ; Sung-Rae Cho ; Jong Chan Kim

MeSH: Analgesics/administration & dosage ; Arthralgia/diagnostic imaging* ; Arthralgia/drug therapy* ; Feasibility Studies ; Female ; Humans ; Hyaluronic Acid/administration & dosage* ; Injections, Intra-Articular/methods* ; Knee Joint/diagnostic imaging* ; Male ; Middle Aged ; Patella/diagnostic imaging* ; Punctures/methods* ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasonography, Interventional/methods*

Abstract: OBJECTIVE: The purpose of this study was to investigate the feasibility of using real-time high-resolution sonography to guide an injection needle into the intra-articular space within the knee.

METHODS: Eighty-nine patients with radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) without an effusion were included. After sonographically guided or blind injection of hyaluronic acid (HA) and contrast dye through a medial patellar portal (MPP) into the knee joint, a radiographic image was made to ascertain whether the injected material had reached the intra-articular space.

RESULT: Sonographically guided injections of HA into the knee joint had a significantly greater accuracy rate (95.6%) than blind injections (77.3%; P = .01).

CONCLUSIONS: Intra-articular injections via an MPP using sonographic guidance may raise the accuracy rate in knee joint injections