so we're going to show the intra to the space we're looking at the lateral aspect of the knee this is distal this is proximal patella is there tibia bossy is there the fibula is here tibia is over here so we're going to come and just look at that superpatellar region and we can see very nicely now the space and you see where the fat pad is there and the quad tendon and if we're going to do an injection this is my preferred way to do injections this direction so we can measure that our entry point is about one centimeter roughly and that we need to have a slight downward trajectory to get down to that area but we don't want to hit the bone we don't want to hit the cartilage and we don't want to hit the tendon so if we come in about a spot right here just kind of enter in what we're going to find is there's our needle right there there it is right there see right there there's our needle and we're right into that joint space immediately you can see that if i were to come down lower you can see that that would put me right unfortunately into where the fat is if i come more approximately up here i'd be into the tendon i don't want to be there so into the joint right there is the ideal spot and i would do an injection you can see the fluid flowing right now you see it flowing you can see it's clearly flowing easily it's not creating a bubble we know we're in the joint it's flowing throughout the joint if it's creating a bubble you're in a fat or in some kind of soft tissue but there's no bubble being formed so we know that we're in the right spot so that's my preferred area the reason why i don't want to go into my kind of where you'd make a portal for that anterior media or intralateral portal of uh arthroscopy is actually it's almost four centimeters away because there's a fat pad behind there's half this fat pad and i get down into the joint you have to go four centimeters and if there's no effusion the joint space is very much small and potentiated and you might actually go into the cruciates so going this direction or this direction is not ideal that's why this region is our best and ideal location for inter-articular injection of the knee
