Accuracy of intra-articular injections for osteoarthritis of the trapeziometacarpal joint.

A study was conducted to determine the accuracy of intra-articular injections for osteoarthritis (OA) of the trapeziometacarpal joint (TMCJ). Over a period of 12 months intra-articular injections on 60 TMCJs (12 males and 48 females) were carried out. All the injections were performed in the operating theatre. The operator inserted the needle into the position clinically assessed to be the TMCJ and the position was assessed using biplanar fluoroscopy. In 42% of cases, the needle was incorrectly placed and its position had to be adjusted, using fluoroscopy, to ensure correct intra-articular placement. Entry into an osteoarthritic TMCJ with a blind passage of the needle is not straightforward. A proper injection technique must be employed to enter the correct joint. Using an image intensifier greatly facilitates accurate needle placement.