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Lower Extremity Joint Injections

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Essentials of Interventional Techniques in Managing Chronic Pain

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Abstract

This chapter reviews the basic pathophysiology, diagnostic principles, relevant anatomy, evidence bases, interventional techniques, and potential complications related to joint injections in the lower extremity. Specifically, this review will focus on the three most common intra-articular injection sites of the lower extremity: the hip, knee, and ankle joints. The commonest underlying disease processes at each joint will be reviewed, as well as the symptomatology, risk factors, and diagnostic criteria. The current literature and level of evidence for each joint injection site will be reviewed. Injection techniques utilizing both fluoroscopy and ultrasound guidance are discussed, as well as multiple approaches for the joint when appropriate. In addition, images of both real fluoroscopic and ultrasound-guided injections will supplement the text to help conceptualize the specific joint anatomy, as well as correct needle placement. The chapter will also provide a basic framework for the clinician to develop an appropriate pre- and postinjection discussion with the patient.

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Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Rajiv Reddy, Ryan Clark & Zachary McCormick

  2. Department of Physical Medicine and Rehabilitation, The Rehabilitation Institute of Chicago, Chicago, IL, USA

    Rajiv Reddy, Ryan Clark & Zachary McCormick

  3. Ventura County Medical Center, Ventura, CA, USA

    George C. Chang Chien

  4. Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA

    Kenneth D. Candido

Authors
  1. Rajiv Reddy
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  2. Ryan Clark
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  3. Zachary McCormick
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  4. George C. Chang Chien
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  5. Kenneth D. Candido
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Corresponding author

Correspondence to Rajiv Reddy .

Editor information

Editors and Affiliations

  1. Pain Management Center of Paducah, Paducah, Kentucky

    Laxmaiah Manchikanti

  2. Department of Anesthesia, LSU Health Science Center, New Orleans, Louisiana, USA

    Alan D. Kaye

  3. Mid Atlantic Spine and Pain Physicians, Newark, Delaware

    Frank J.E. Falco

  4. Service Line Chief of Interventional Radiology, Director of Interventional Neuroradiology, Chief of NeuroInterventional Spine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Joshua A. Hirsch

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Reddy, R., Clark, R., McCormick, Z., Chang Chien, G.C., Candido, K.D. (2018). Lower Extremity Joint Injections. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-60361-2_43

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  • DOI: https://doi.org/10.1007/978-3-319-60361-2_43

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60359-9

  • Online ISBN: 978-3-319-60361-2

  • eBook Packages: MedicineMedicine (R0)

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