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A Standardized Acupotomy Protocol For The Treatment of Tenosynovitis of Hand Flexor Tendons In Human Patients

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Sonographically guided flexor hallucis longus tendon sheath injection.

Amir Mehdizade¹, Ronald S Adler

¹Department of Radiology and Imaging, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 E 70th St, New York, NY 10021 USA.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine

|January 27, 2007

Summary

This study details a sonographically guided technique for flexor hallucis longus (FHL) tendon sheath injections. Ultrasound guidance ensures accurate medication delivery, offering an effective alternative for FHL corticosteroid administration.

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Area of Science:

Musculoskeletal imaging
Interventional radiology
Podiatric medicine

Background:

Flexor hallucis longus (FHL) tendon sheath injections are used therapeutically.
Accurate needle placement is crucial for effective FHL injections.
Sonographic guidance offers real-time visualization for precise needle placement.

Purpose of the Study:

To describe a sonographically guided technique for FHL tendon sheath injections.
To highlight the advantages of ultrasound guidance in this procedure.

Main Methods:

Utilized an intermediate-frequency linear transducer (7.5-12 MHz) in the axial plane.
Patients were positioned prone with the transducer on the posteromedial ankle.
A 25-gauge or 22-gauge needle was advanced into the FHL tendon sheath under real-time ultrasound visualization for injection.

Main Results:

Successfully performed 24 injections in 20 patients (12 female, 8 male; age 22-64).
Achieved desired endpoint of FHL tendon sheath distention in all cases.
No long-term complications were reported, aside from minor transient paresthesias.

Conclusions:

A reliable sonographically guided technique for FHL tendon sheath injections is described.
Sonography allows for real-time needle visualization and precise medication delivery.
Ultrasound guidance is proposed as an excellent alternative for FHL corticosteroid injections.