title: Can the carpometacarpal joint be injected accurately in the office setting? Implications for therapy.
abstract: OBJECTIVE
  To investigate whether carpometacarpal (CMC) injections can be performed accurately in the office setting in patients with moderate to severe CMC osteoarthritis (OA).
  
  
  METHODS
  Patients were recruited from rheumatology and hand surgical practices as part of an open label trial of hylan G-F 20 for CMC OA. CMC injections were performed without radiologic guidance, using anatomic landmarks to guide needle placement. Once injected, the patient was immediately taken to an adjacent ultrasound suite, and the injected CMC joint examined for evidence of intraarticular material and air microbubbles.
  
  
  RESULTS
  Thirty-two patients were injected. All patients had ultrasound evidence of intraarticular material: 91% also had evidence of microbubbles in the joint.
  
  
  CONCLUSIONS
  CMC injections can be performed accurately in the office setting, without the need for radiologic guidance, in patients with moderate to severe CMC OA.
authors.affiliation: Department of Medicine, Hospital for Special Surgery, New York, New York, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Mandl
authors.forename: Robert N
authors.initials: RN
authors.lastname: Hotchkiss
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Adler
authors.forename: Lily A
authors.initials: LA
authors.lastname: Ariola
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D000553:Ambulatory Care; D050824:Carpal Joints / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D007270:Injections, Intra-Articular / Q000379:methods*; D050279:Metacarpal Bones / Q000000981:diagnostic imaging / Q000473:pathology*; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D010045:Outpatients; D015203:Reproducibility of Results; D014463:Ultrasonography
chemical_list: D000276:Adjuvants, Immunologic; C049816:hylan; D006820:Hyaluronic Acid