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Pain and Spine Medicine

Needle depth of fluoroscopically guided intra-articular corticosteroid injection

(Scientific Session) Needle Depth of Fluoroscopically Guided Intra-articular Corticosteroid Injection

Thursday, November 16, 2023
3:45 PM – 5:00 PM CT
Location: CC 216
Background and/or Objectives: To determine depth of needle required to inject into knee intra-articular space

Design: Prospective cohort study.

Setting: Academic teaching hospital.

Participants: 27 subjects who underwent knee joint injection under fluoroscopic guidance

Interventions: Patients all received a knee injection with the aid of fluoroscopy with the knee in 90-degree flexed position, via an inferior medial approach, similar to landmark-based approach.

Main Outcome Measures: Contrast was used with the needle hub “buried” with the 1.5-inch needle. If the contrast did not show intraarticular joint spread, long needle was used. Intraarticular spread was confirmed, and the depth was recorded.

Results: Of the 27 subjects, 1.5-inch needle was successful in 12 patients (44.4%). Longer needles were required in 15 (55.6%) with average length of 2.27 inches. Average BMI was 34.3 for the 1.5-inch needle patients compared to 46.9 BMI in those requiring longer needles.

Conclusions: A 1.5-inch needle may not be appropriate for successful intraarticular knee placement in patients with BMI >35.