Sonographically guided costotransverse joint injections: a computed tomographically controlled cadaveric feasibility...

Area of Science:

• Musculoskeletal radiology
• Interventional pain management
• Ultrasound-guided procedures

Background:

• Costotransverse (CTRV) joint injections are used for thoracic pain.
• Fluoroscopic guidance is the standard, but ultrasound offers potential advantages.
• A novel sonographically guided technique for CTRV joint injections was developed.

Purpose of the Study:

• To describe and validate a novel sonographically guided costotransverse (CTRV) joint injection technique.
• To assess the accuracy and feasibility of ultrasound guidance for CTRV joint injections.

Main Methods:

• A cadaveric specimen (T3-T10 CTRV joints) was used.
• Ultrasound guidance and an in-plane needle approach were employed.
• CT imaging confirmed needle tip placement and contrast distribution.

Main Results:

• 16 sonographically guided CTRV joint injections were performed.
• 68.8% (11/16) of injections successfully placed contrast into the target joint.
• 54.5% (6/11) of intra-articular injections had >50% injectate within the joint capsule.

Conclusions:

• Sonographically guided CTRV joint injections are feasible.
• The 68.8% accuracy rate compares favorably to fluoroscopic guidance (76%).
• Further research is warranted to establish the role of ultrasound in managing thoracic pain syndromes.