Scaphotrapeziotrapezoid (STT) Joint Injection

Scaphotrapeziotrapezoid (STT) Joint Injection
Indication
Needle	25-gauge 38mm

Indications and Efficacy

Main article: Scaphotrapeziotrapezoid Joint Pain

Scaphotrapeziotrapezoid (STT) joint osteoarthritis is the second most common pattern of wrist arthritis. The typical clinical picture is activity-related dorsal or radial sided wrist pain in older patients along with reduced grip strength and variable motion loss. The diagnosis of STT joint pain is challenging. Ultrasound guided injection of the joint can aid in making the diagnosis of pain arising from this joint.

Technique

Ultrasound Guided

• Palmar approach, with palm facing ceiling
• Identify the STT joint
  • Place the transducer parallel to the long axis of the metacarpal of the thumb.
  • Translate the transducer proximally to identify the carpometacarpal joint.
  • Translate the probe further proximally still to identify the STT joint, the thick palmar scaphotrapezoidal ligament, and the joint capsule.
  • Visualise the joint space between the scaphoid and trapezium, just radial to the flexor carpi radialis. The scaphoid can be confirmed by seeing it's waist.
  • Visualise the superficial palmar branch of the radial artery within the subcutaneous tissue over the scaphoid tubercle.

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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