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Related Experiment Videos

Subtalar Joint Arthrography.

Michael K. Ruhoy1, Arthur H. Newberg, Marilyn L. Yodlowski

  • 1Department of Radiology, New England Baptist Hospital, Boston, Massachusetts.

Seminars in Musculoskeletal Radiology
|June 2, 2001
PubMed
Summary
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The anterolateral approach for posterior subtalar (PST) joint arthrography and anesthetic injection is more accurate and safer than the posteromedial approach for hindfoot pain diagnosis. This optimized technique improves diagnostic accuracy.

Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Pain Management

Background:

  • Hindfoot pain diagnosis often requires precise imaging and targeted anesthetic blocks.
  • Posterior talocalcaneal/posterior subtalar (PST) joint injections are crucial for evaluating hindfoot pain etiology.
  • Optimizing the technique for PST joint arthrography and anesthetic injection is essential for diagnostic accuracy.

Purpose of the Study:

  • To determine the accuracy and specificity of an optimal technique for posterior talocalcaneal/posterior subtalar (PST) joint arthrography and anesthetic injection.
  • To compare the posteromedial and anterolateral approaches for PST joint procedures in patients with hindfoot pain.

Main Methods:

  • Fifty-five PST joints in 55 patients with hindfoot pain were studied.
  • Procedures involved contrast injection followed by a mixture of lidocaine and bupivacaine.

Related Experiment Videos

  • Two approaches were evaluated: posteromedial (n=24) and anterolateral (n=31).
  • Ease of performance, confirmation of needle position, and adverse effects were recorded.

    • Main Results:

    • Forty-seven arthrographically confirmed PST injections were achieved.
    • The posteromedial approach was more difficult, with three cases of tendon sheath opacification and four of unwanted toe anesthesia.
    • The anterolateral approach was technically easier, with no extra-articular structures visualized or anesthetized.

    Conclusions:

    • The anterolateral approach is the optimized technique for PST joint arthrography and anesthetic injection.
    • This approach offers improved safety and efficacy in diagnosing hindfoot pain compared to the posteromedial route.