• Ki Deok Park, Jae Ki Ahn, Sang-Chul Lee, Jihae Lee, Jongwoo Kim, and Yongbum Park.
• From the Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Republic of Korea (KDP); Department of Physical Medicine & Rehabilitation (JKA, YP), Department of Radiology (JL), and Department of Family Medicine (JK), Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea; and Department of Rehabilitation Medicine, Myonggji Hospital, Kwandong University College of Medicine, Goyang, Republic of Korea (S-CL).
• Am J Phys Med Rehabil. 2013 Nov 1; 92 (11): 990-8.

ObjectiveThe objective of this study was to examine the accuracy of ultrasound-guided intra-articular (IA) injections on three different sites of the knee using midmedial, midlateral, and superolateral portals.DesignUltrasound-guided IA injection and a radiographic evaluation were performed on 120 knees with osteoarthritis. Five milliliters of a mixed material consisting of 1% lidocaine (1 ml), 20 mg of triamcinolone (1 ml), and nonionic contrast (3 ml) was injected into the IA space of the knee through three different portals. After each injection, a radiographic evaluation was performed to determine whether the injected material had reached the IA space or infiltrated into the soft tissue.ResultsOf 40 injections administered through the midmedial portal, 38 were confirmed as having been placed in the IA space on the first attempt (95% accuracy rate). Thirty-nine of 40 injections administered through the midlateral portal were IA on the first attempt (98.5% accuracy rate), as were 40 of 40 injections administered through a superolateral portal (100% accuracy rate). No significant differences (P > 0.05) were observed in the accuracy rate obtained with placement through the midmedial, midlateral, and superolateral portals.ConclusionsAll three ultrasound-guided IA injections may be used to access the knee joint, with a high rate of accuracy.

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