Ultrasound-guided infiltration of rhizarthrosis

What is Ultrasound-Guided Injection for Rhizarthrosis?

Ultrasound-guided injection for rhizarthrosis is a procedure that uses ultrasound guidance to inject anti-inflammatory medication into the trapeziometacarpal joint in cases where this joint is degenerated and affected by osteoarthritis (rhizarthrosis).

There are various degrees of joint involvement, with deformity, pain, and loss of function increasing as the degree increases. Undoubtedly, rehabilitation plays an important role in pain control and functional improvement in rhizarthrosis, but in cases where rehabilitation treatment is ineffective, ultrasound-guided injection for rhizarthrosis may be indicated. In this case, ultrasound-guided injection provides us with a tool to treat rhizarthrosis quickly, safely, and accurately. Precision is very important in small joints that, due to their degenerative process, can be difficult to inject without ultrasound guidance.

What are the indications for ultrasound-guided injections for rhizarthrosis?

• Persistent and resistant pain: Injections are indicated when pain caused by rhizarthrosis does not improve with first-line treatments such as activity modification, physical therapy, or oral anti-inflammatory medications.
• Joint inflammation: If the joint at the base of the thumb is swollen and painful, intra-articular corticosteroid injections can provide significant relief by reducing inflammation.
• Improving function and range of motion: By reducing pain and inflammation, injections can help the patient regain some lost mobility and perform daily activities with less difficulty.
• Delaying surgery: Injections are an option for patients seeking to postpone or avoid surgery. They can offer temporary relief that allows the patient to resume their activities while other treatment options are evaluated.
• Application of other treatments: In addition to corticosteroids, injections are often used to inject other substances such as hyaluronic acid (which acts as a lubricant and cartilage protector) or growth factors (such as PRP or Platelet-Rich Plasma), seeking a longer-lasting or disease-modifying effect. Ultrasound guidance is especially useful to ensure proper placement of these products.

What is the procedure for an ultrasound-guided injection for rhizarthrosis?

The procedure for an ultrasound-guided injection of the trapeziometacarpal joint includes:

• Patient positioning: seated on a stool with the hand to be injected laterally.
• Preliminary ultrasound: where we will locate the joint line of the trapeziometacarpal joint and its joint capsule. We perform skin marking of the needle entry point.
• Asepsis: of the area to be injected and of the materials and instruments used.
• Ultrasound guidance: We visualize the needle in the correct position and the medication being administered in the correct location.

The main goal of ultrasound-guided injections for rhizarthrosis is to improve pain and hand function. This goal is not always achieved, especially in cases of rhizarthrosis with a high degree of joint involvement. In these cases, surgery will be indicated, and ultrasound-guided injections can be used as a technique to alleviate pain until surgery.

Book an appointment with Dr. Jordi Jiménez. He will see you at the center of Palma de Mallorca and help you regain your quality of life.