Abstract

Ultrasound guidance is valuable for performing precise joint interventions. Joint interventions may be requested for therapeutic and diagnostic pain injections, joint aspiration in the setting of suspected infection, or contrast injection for arthrography. In practice, interventions of the shoulder girdle, elbow, and hand/wrist joints may be performed without any imaging guidance. However, imaging guidance results in more accurate interventions and better patient outcomes than those performed by palpation alone. When compared to other modalities used for imaging guidance, ultrasound has many potential advantages. Radiologists should be prepared to perform ultrasound-guided upper extremity joint interventions utilizing recommended techniques to optimize clinical practice and patient outcomes.

Key points

1. Ultrasound-guided injections of the glenohumeral, acromioclavicular, sternoclavicular, elbow, and hand/wrist joints have higher accuracy than injections performed without imaging guidance.

2. Ultrasound-guided aspirations of upper extremity joints have advantages to fluoroscopic-guided aspirations because of the potential to identify effusions, soft tissue abscess, or bursitis.

3. Ultrasound-guided contrast injection prior to MR arthrography is as accurate as fluoroscopic-guided injection for upper extremity joints.

中文翻译：

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上肢关节的超声引导干预

摘要

超声引导对于进行精确的关节干预很有价值。可能需要进行关节干预以进行治疗性和诊断性疼痛注射、疑似感染情况下的关节抽吸或关节造影术的造影剂注射。在实践中，肩胛带、肘部和手/腕关节的干预可以在没有任何影像引导的情况下进行。然而，与仅通过触诊进行的那些相比，影像引导导致更准确的干预和更好的患者结果。与用于成像引导的其他方式相比，超声具有许多潜在优势。放射科医生应准备好利用推荐的技术进行超声引导的上肢关节干预，以优化临床实践和患者预后。

关键点

1. 超声引导的盂肱关节、肩锁关节、胸锁关节、肘关节和手/腕关节的注射比没有影像引导的注射具有更高的准确性。

2. 上肢关节的超声引导抽吸比荧光镜引导抽吸具有优势，因为它可以识别积液、软组织脓肿或滑囊炎。

3. MR 关节造影前超声引导造影剂注射与上肢关节荧光镜引导注射一样准确。