Ankle Joint Injection

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Ankle Joint Injection
Indication
Syringe	3mL
Needle	23G 30mm
Steroid	30mg triamcinolone
Local	2mL 2% lidocaine
Volume	2-3mL

Technique

Landmark Guided

Lateral and medial ankle arthrocentesis approaches

Medial Approach (tibiotalar)

• Position: Supine with foot perpendicular to leg
• Identify and mark sulcus lateral to the medial malleolus and medial to the tibialis anterior and extensor hallucis longus tendons
• Plantarflex the foot with needle entering the skin overlying the sulcus
• Angle the needle slightly cranially as it passes between the medial malleolus and tibialis anterior tendon

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  Medial approach: enter space between anterior border of the medial malleolus and the tibialis anterior tendon

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  Medial approach: have patient lie supine, and plantar flex the ankle so the angle is close to 90 degrees.

Lateral Approach (subtalar)

• Keep foot perpendicular to leg
• Enter subtalar joint just below tip of lateral malleolus
• Direct needle medially toward joint space

Literature Review

Literature Review

Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf

Articles from all years: PubMed search, Google Scholar search.

TRIP Database: clinical publications about evidence-based medicine.

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