title: Sonographically guided therapeutic injections in the meniscoid lesion in patients with anteromedial ankle impingement syndrome.
abstract: We describe a sonographically guided technique to perform therapeutic injections for anteromedial ankle impingement syndrome. Scans are carried out using a high-frequency small footprint linear array transducer, positioned along the anteromedial aspect of the tibiotalar joint. A 25 gauge needle is advanced under direct sonographic guidance into the "meniscoid lesion" (area of scarring), and a standardized therapeutic mixture is injected extra-articularly. Image-guided injections have a positive influence on clinical decision making by improving patient management, increasing the accuracy of diagnosis, and decreasing patient pain. Sonography allows confirmation of correct injection placement, resulting in increased accuracy and more successful patient outcomes.
  
  
  METHODS
  Therapeutic, Level V, Expert Opinion.
authors.affiliation: Departmenst of Radiology (JJ, TM), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FloridaOrthopedics (BL, LK), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida jjose@med.miami.edu.
authors.forename: Jean
authors.initials: J
authors.lastname: Jose
authors.affiliation: Departmenst of Radiology (JJ, TM), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FloridaOrthopedics (BL, LK), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Tarun
authors.initials: T
authors.lastname: Mirpuri
authors.affiliation: Departmenst of Radiology (JJ, TM), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FloridaOrthopedics (BL, LK), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Bryson
authors.initials: B
authors.lastname: Lesniak
authors.affiliation: Departmenst of Radiology (JJ, TM), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FloridaOrthopedics (BL, LK), Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Lee
authors.initials: L
authors.lastname: Kaplan
mesh_terms: D000777:Anesthetics / Q000008:administration & dosage*; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000777:Anesthetics; D005938:Glucocorticoids
keywords: ankle sonography; anteromedial ankle impingement syndrome; meniscoid lesion; musculoskeletal ultrasound; sonographically guided injection