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    Does ultrasound guidance improve the outcomes of arthrocentesis and corticosteroid injection of the knee?

    Access Status
    Fulltext not available
    Authors
    Sibbitt, W.
    Kettwich, L.
    Band, P.
    Chavez-Chiang, N.
    Delea, S.
    Haseler, Luke
    Bankhurst, A.
    Date
    2012
    Type
    Journal Article
    
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    Citation
    Sibbitt, W. and Kettwich, L. and Band, P. and Chavez-Chiang, N. and Delea, S. and Haseler, L. and Bankhurst, A. 2012. Does ultrasound guidance improve the outcomes of arthrocentesis and corticosteroid injection of the knee?. Scandinavian Journal of Rheumatology. 41 (1): pp. 66-72.
    Source Title
    Scandinavian Journal of Rheumatology
    DOI
    10.3109/03009742.2011.599071
    ISSN
    0300-9742
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/58896
    Collection
    • Curtin Research Publications
    Abstract

    Objective: The present randomized controlled trial compared arthrocentesis of the effusive knee followed by corticosteroid injection performed by the conventional anatomic landmark palpation-guided technique to the same procedure performed with ultrasound (US) needle guidance. Methods: Sixty-four palpably effusive knees were randomized to (i) palpation-guided arthrocentesis with a conventional 20-mL syringe (22 knees), (ii) US-guided arthrocentesis with a 25-mL reciprocating procedure device (RPD) mechanical aspirating syringe (22 knees), or (iii) US-guided arthrocentesis with a 60-mL automatic aspirating syringe (20 knees). The one-needle two-syringe technique was used. Outcome measures included patient pain by the Visual Analogue Scale (VAS) for pain (010 cm), the proportion of diagnostic samples, synovial fluid volume yield, complications, and therapeutic outcome at 2 weeks. Results: Sonographic guidance resulted in 48% less procedural pan (VAS; palpation-guided: 5.8 ± 3.0 cm, US-guided: 3.0 ± 2.8 cm, p < 0.001), 183% increased aspirated synovial fluid volumes (palpation-guided: 12 ± 10 mL, US-guided: 34 ± 25 mL, p < 0.0001), and improved outcomes at 2 weeks (VAS; palpation-guided: 2.8 ± 2.4 cm, US-guided: 1.5 ± 1.9 cm, p = 0.034). Outcomes of sonographic guidance with the mechanical syringe and automatic syringe were comparable in all outcome measures. Conclusions: US-guided arthrocentesis and injection of the knee are superior to anatomic landmark palpation-guided arthrocentesis, resulting in significantly less procedural pain, improved arthrocentesis success, greater synovial fluid yie ld, more complete joint decompression, and improved clinical outcomes. © 2011 Informa Healthcare on behalf of The Scandinavian Rheumatology Research Foundation.

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