Literature DB >> 30479639

Accuracy of ultrasound-guided versus palpation-based carpometacarpal joint injections: A randomized pilot study in cadavers.

Armen Derian1, Julia Amundson2, Karl Abi-Aad3, Ricardo Vasquez-Duarte1, Douglas Johnson-Greene1.   

Abstract

OBJECTIVE: To determine the accuracy of ultrasound guidance compared to palpation in performing carpometacarpal joint injections in cadavers.
DESIGN: In all, 36 carpometacarpal joints were randomized to either ultrasound-guided or palpation-based injections, with 1 cc of blue latex solution injected into each joint. The specimens were then dissected and the distribution of the latex was assessed by two independent, blinded raters. Injection accuracy was evaluated on a four-point quartile rating scale of 1-4, corresponding to the amount of the latex solution within the joint (1 = 0-25%, 2 = 26-50%, 3 = 51-75%, 4 = 76-100%). Inter-rater reliability was a secondary measure.
RESULTS: The mean rating of accuracy was 2.1 for both palpation-based and ultrasound-guided injections. There was no statistically significant difference in accuracy between the two injectors. Chi-square analysis testing differences in accuracy for the two conditions was not statistically significant. The Cronbach's alpha for rater 2 was 0.74, which represents an acceptable level of reliability. A Friedman's Chi-square for the two raters was 2.3 (p = 0.13), indicating no significant difference between raters.
CONCLUSION: Ultrasound guidance did not improve the accuracy of carpometacarpal joint injections in cadavers. However, the high inter-rater reliability attests to the value of the novel assessment scale.

Entities:  

Keywords:  Ultrasound; accuracy; carpometacarpal joint; injection; ultrasound guided injections

Year:  2018        PMID: 30479639      PMCID: PMC6243451          DOI: 10.1177/1742271X18789711

Source DB:  PubMed          Journal:  Ultrasound        ISSN: 1742-271X


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