Ultrasound guidance improves results of arthrocentesis of medium-sized joint effusions: Study
Ultrasound-guided (USG) is better than landmark-guided (LMG) medium-sized joint arthrocentesis, according to a recent study published in the Academic Emergency Medicine.
Joint and soft tissue injections are frequent procedures in rheumatological practice, but it is recognised that the success rate with which injections reach their intended target using anatomical landmarks as guidance is limited.1 High-resolution ultrasound (US) is a valid, "bed-side" imaging technique,2 which is increasingly used in rheumatological practice for diagnostic purpose, but also as image guidance for needle arthrocentesis to perform aspirations, injections or synovial biopsies
Arthrocentesis is commonly performed in the emergency department, but success rates vary based on location. Presently, there is a paucity of data assessing the utility of ultrasound-guided (USG) medium-sized joint arthrocentesis. The objective of this study was to compare the success of USG and landmark-guided (LMG) medium-sized joint arthrocentesis.
This was a single-centre, prospective, randomized clinical trial (NCT03327584) of a convenience sample of adult patients who presented to an urban, university hospital with > 105,000 visits annually. Patients with a suspected medium-sized joint effusion (defined as elbow, wrist, or ankle) undergoing arthrocentesis were randomized into LMG or USG using the GE Logiq e linear transducer (4–10 MHz). The following patients were excluded: on anticoagulation, with soft tissue infection overlying the joint, or involving an artificial joint. Statistical analysis included the Fisher exact, Mann-Whitney U-test, and t-test.
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