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00:25
Hi, I'm John Fowler from University of Pittsburgh. I'm an orthopedic hand surgeon. I'm going to talk to you today about using ultrasound for diagnosis and also for injections of thumb CMC arthritis. So I'm going to place the patient's hand like this. I always have them kind of let their thumb droop a little bit.
And then you're going to place the transducer in the long axis. And we're gonna set it down right here. And we are going to start to see the thumb metacarpal right here. And then I go a little bit deeper.
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We'll see the trapezium. So trapezium down here. Thumb metacarpal right there. And that's the joint space. She does have some early arthritis. We can start to see like a little bit of an osteo fight kind of showing up right there. And she has a little bit of fluid in her joint as we see in early arthritis. So you know diagnostically obviously X-rays are better than ultrasound.
But this is how we do our injection. My colleagues often make fun of me for using ultrasound for thumb CMC injections, but it does make sure you get the needle in the joint, which is nice. So I would come from proximal to distal. I'd place the needle right here. We'd see the needle come across the screen and go right into the joint and then inject the fluid.
And most studies would show that you have more accuracy with using ultrasound guidance than doing landmark based, although that that difference may not be clinically relevant.
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01:09
So that concludes my ultrasound video of thumb CMC arthritis.