Ultrasound-guided procedures

Abstract

Needle aspiration of synovial fluid and intralesional injection of various compounds are very common procedures in rheumatological practice. Local steroid injection, in particular, is relatively simple and cost-effective and may be alternative or adjunctive to systemic drug therapy in several rheumatological conditions [1]–[5]. Both efficacy and side effects of the injection depend on the correct placement of the tip of the needle inside or around the lesion. Particular attention must be taken to avoid direct needle contact with nerves, tendons, articular cartilage and blood vessels [6]. Intra-articular and intra-lesional therapy is usually performed using palpation and bony landmarks for guidance. Conventional blind interventional procedures may be particularly problematic when a small and/or deep target has to be reached, or when an injection has to be carried out into a dry joint