Dr. Alan Hirahara performs an intra-articular hyaluronic acid injection using ultrasound guidance to bring pain relief to a patient suffering from degenerative joint disease in her knees. Suprapatellar access to the knee joint space provides easy and painless entry even without a joint effusion present.
hi my name is alan hirohara from sacramento california we'll be doing a injection under ultrasound guidance to the right knee using hyaluronic acid for degenerative joint disease specifically we're going to be using the ultrasound because as we look into the knee itself we see the trochlea very nicely and we're super patellar in this region we can nicely see the quad see there's very little joint fluid within the space there and that'd be very hard potentially hit if we do this blindly so obviously we don't want to hit the the bone we don't want to hit the cartilage and we definitely don't want to get into that tendon or that could be very painful so this allows us easy access but you can see that the access is literally about a millimeter space to get in so let me get started and based off my estimates here we're looking at roughly about two and a half centimeters or 2.1 centimeters to get in so we can identify the specific space that we want to enter to make sure we get into the right spot so first we'll clean it up get it prepped up and ready for the injection i'm going to use ethyl chloride to numb up the skin and then we'll be able to do our injection and there we go right there all right and shot and a little high and reorient to be a little bit lower got down right there and we're right into the space perfectly now i'm injecting you can see it flowing all the way on that lateral aspect so we know in the right spot so we knew in the joint but we saw that flow occur laterally so we knew we were in the right spot you
