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Accuracy of Ultrasound‐Guided Versus Palpation‐Guided Acromioclavicular Joint Injections: A Cadaveric Study
Author(s) -
Peck Evan,
Lai Jim K.,
Pawlina Wojciech,
Smith Jay
Publication year - 2010
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2010.06.009
Subject(s) - palpation , medicine , cadaveric spasm , acromioclavicular joint , ultrasound , prospective cohort study , radiology , surgery , physical therapy
Objective To describe a technique for sonographically guided acromioclavicular joint (ACJ) injections and compare its accuracy to palpation‐guided injections in a cadaveric model. Design Prospective laboratory investigation. Setting Procedural skills laboratory at a tertiary medical center. Methods A single experienced operator completed 10 sonographically guided and 10 palpation‐guided ACJ injections in unembalmed cadavers. Injection order was randomized and all injections were completed with diluted colored latex. Co‐investigators blinded to the injection technique dissected each specimen and graded colored latex location as accurate (in the ACJ), partially accurate (within and outside the ACJ), or inaccurate (no latex in the ACJ). Main Outcome Measurements Direct assessment of injected dye within the ACJ via dissection. Results All 10 sonographically guided ACJ injections accurately placed latex into the ACJ (100% accuracy), whereas only 4 of 10 (40%) palpation‐guided injections accurately placed latex within the ACJ ( P = .0054). Conclusions This cadaveric investigation suggests that sonographic guidance can be used to inject the ACJ with a high degree of accuracy, and should be considered superior to palpation guidance. Clinicians should consider using sonographic guidance to inject the ACJ when diagnostic specificity is paramount or when otherwise clinically indicated.