Accuracy of Injection Into the Basal Joint of the Thumb
Mark A. Pollard, MD, Mary Beth Cermak, MD, Walter R. Buck, PhD, and D. Patrick Williams, MD
At the time of writing, Dr. Pollard was Resident, Hamot Medical Center, Erie, Pennsylvania. Currently, he is Orthopaedic Surgeon, Cooper Bone and Joint Institute, Cooper University Hospital, Camden, New Jersey.
Dr. Cermak is Orthopaedic Surgeron, Hamot Medical Center, Erie, Pennsylvania.
Dr. Buck is Professor of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania.
Dr. Williams is Orthopaedic Surgeon, Department of Orthopaedic Surgery, Hamot Medical Center, Erie, Pennsylvania.
To investigate the accuracy of intra-articular injection of the basal joint and to determine the rate of soft-tissue extravasation of injected material in successful intra-articular injection, we injected the basal joint of 30 hands with radiopaque dye (with fluoroscopy guiding needle placement in 8 cases) and then used fluoroscopy to check injection accuracy. Results were recorded depending on the location of the injected dye on fluoroscopic examination. Rates of intra-articular accuracy and soft-tissue extravasation for successful intra-articular injections were 100% and 25% for the fluoroscopyguided group and 81.8% and 25% for the “blind” group. This study’s accuracy rate for intra-articular injection of the basal joint is comparable to the rates reported for injection of larger joints. There is a relatively high soft-tissue extravasation rate for successful intra-articular injection.