title: The accuracy of ultrasound-guided and palpation-guided peroneal tendon sheath injections.
abstract: OBJECTIVE
  The aim of this study was to describe and to validate an ultrasound-guided peroneal tendon sheath (PTS) injection technique and to compare the accuracy of ultrasound-guided vs. palpation-guided PTS injections in a cadaveric model.
  
  
  METHODS
  Twenty cadaveric lower limbs were injected with and without ultrasound guidance, using a different color of liquid latex for each injection technique. The injections were performed by a single investigator in a randomized order. Cadaveric specimens were dissected 1 wk later by a blinded investigator who graded injection accuracy on a 3-point scale (1, accurate; 2, partially accurate; 3, inaccurate).
  
  
  RESULTS
  Ultrasound-guided injections were 100% (20 of 20) accurate whereas palpation-guided injections were 60% (12 of 20) accurate (P = 0.008). Six palpation-guided injections were partially accurate, and two were inaccurate. Two of the partially accurate and both of the inaccurate injections were intratendinous.
  
  
  CONCLUSIONS
  In a cadaveric model, ultrasound-guided PTS injections are significantly more accurate than palpation-guided injections. When performing PTS injections, clinicians should consider ultrasound guidance to improve injection accuracy and minimize potential complications such as intratendinous injection.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Mayo Clinic Sports Medicine Center, Rochester, Minnesota, USA.
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Muir
authors.forename: Heather M
authors.initials: HM
authors.lastname: Curtiss
authors.forename: John
authors.initials: J
authors.lastname: Hollman
authors.forename: Jay
authors.initials: J
authors.lastname: Smith
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Finnoff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D002102:Cadaver; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010173:Palpation; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted; D013710:Tendons / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional