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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1465-1470 • 0278-4297

Feasibility of Sonography for Intra-articular Injections in the Knee Through a Medial Patellar Portal

Sang Hee Im, MD, Sang Chul Lee, MD, PhD, Yong Bum Park, MD, Sung-Rae Cho, MD, PhD and Jong Chan Kim, MD

Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, School of Medicine, Jeju National University, Jeju, Korea (S.H.I.); Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, Koyang, Kyunggi, Korea (S.C.L., J.C.K.); Department of Physical Medicine and Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea (Y.B.P.); and Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea (S.-R.C.).

Address correspondence to Sang Chul Lee, MD, PhD, Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, 697-24 Hwajung-dong, Dokyang-ku, Koyang, Kyunggi 412-270, Korea. E-mail: bettertomo{at}naver.com

Objective. The purpose of this study was to investigate the feasibility of using real-time high-resolution sonography to guide an injection needle into the intra-articular space within the knee. Methods. Eighty-nine patients with radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) without an effusion were included. After sonographically guided or blind injection of hyaluronic acid (HA) and contrast dye through a medial patellar portal (MPP) into the knee joint, a radiographic image was made to ascertain whether the injected material had reached the intra-articular space. Result. Sonographically guided injections of HA into the knee joint had a significantly greater accuracy rate (95.6%) than blind injections (77.3%; P = .01). Conclusions. Intra-articular injections via an MPP using sonographic guidance may raise the accuracy rate in knee joint injections.

Key Words: injection • knee • sonography

Abbreviations: HA, hyaluronic acid • MPP, medial patellar portal • MRI, magnetic resonance imaging • OA, osteoarthritis

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