Sonographically guided therapeutic injections in the meniscoid lesion in patients with anteromedial ankle impingement syndrome.

UNLABELLED: We describe a sonographically guided technique to perform therapeutic injections for anteromedial ankle impingement syndrome. Scans are carried out using a high-frequency small footprint linear array transducer, positioned along the anteromedial aspect of the tibiotalar joint. A 25 gauge needle is advanced under direct sonographic guidance into the "meniscoid lesion" (area of scarring), and a standardized therapeutic mixture is injected extra-articularly. Image-guided injections have a positive influence on clinical decision making by improving patient management, increasing the accuracy of diagnosis, and decreasing patient pain. Sonography allows confirmation of correct injection placement, resulting in increased accuracy and more successful patient outcomes. LEVELS OF EVIDENCE: Therapeutic, Level V, Expert Opinion.