Dr. Jay Smith from the Mayo Clinic and an alumni of The Orthobiologic Institute (TOBI) recently published a new article in The Journal of Ultrasound Medicine titled Sonographically Guided Posterior Subtalar Joint Injection via the Sinus Tarsi Approach
An investigation of ten unembalmed, cadaveric ankle-foot specimens was used to determine the feasibility and accuracy of sonographically guided posterior subtalar joint injections (PTSJ) performed through the sinus tarsi. A single injector utilized an anterior to posterior approach parallel to the calcaneal surface to inject 2mL and 4mL of tap water into the joint space. Ultrasound analysis was performed before and after to determine fluid deposition in the posterior and lateral PSTJ recesses along with peroneal tendon sheath.
The ultrasound analysis demonstrated that 2mL of injectate accurately distended the posterior recess with only 20% achieving lateral recess distension. However, injecting the larger volume (4mL) distended both recesses in all specimens. The distension observed was similar to that of contrast agent injection in two additional specimens and a similar CT guided approach. In addition, there was no fluid found surrounding the peroneal tendon sheath which has been described by other approaches into this space.
This study demonstrates that sonographically guided posterior subtalar joint injections via the sinus tarsi can accurately deliver the desired injectate throughout the posterior subtalar joint and its effectiveness and spread appears to be volume dependent.
For more of the latest research on regenerative medicine and hands-on musculoskeletal ultrasound cadaver lab, be sure to attend TOBI 2015:
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June 12-14, 2015
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