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American Journal of Physical Medicine & Rehabilitation:
doi: 10.1097/PHM.0b013e31821f6e63
Original Research Articles: Ultrasound

The Accuracy of Ultrasound-Guided and Palpation-Guided Peroneal Tendon Sheath Injections

Muir, Jeffery J. MD; Curtiss, Heather M. MD; Hollman, John PT, PhD; Smith, Jay MD; Finnoff, Jonathan T. DO

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Abstract

Objective: The aim of this study was to describe and to validate an ultrasound-guided peroneal tendon sheath (PTS) injection technique and to compare the accuracy of ultrasound-guided vs. palpation-guided PTS injections in a cadaveric model.

Design: Twenty cadaveric lower limbs were injected with and without ultrasound guidance, using a different color of liquid latex for each injection technique. The injections were performed by a single investigator in a randomized order. Cadaveric specimens were dissected 1 wk later by a blinded investigator who graded injection accuracy on a 3-point scale (1, accurate; 2, partially accurate; 3, inaccurate).

Results: Ultrasound-guided injections were 100% (20 of 20) accurate whereas palpation-guided injections were 60% (12 of 20) accurate (P = 0.008). Six palpation-guided injections were partially accurate, and two were inaccurate. Two of the partially accurate and both of the inaccurate injections were intratendinous.

Conclusions: In a cadaveric model, ultrasound-guided PTS injections are significantly more accurate than palpation-guided injections. When performing PTS injections, clinicians should consider ultrasound guidance to improve injection accuracy and minimize potential complications such as intratendinous injection.

© 2011 Lippincott Williams & Wilkins, Inc.

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