II. Indications
- Ankle Osteoarthritis
- Other persistent and refractory ankle Arthritis
- Diagnostic aspiration
III. Contraindications
- Ankle infection contraindicates steroid injection
IV. Preparation
- Needle
- Gauge: 25 to 27 (18 to 21 if aspirating)
- Length: 1.5 inches
- Syringe: 10 ml (larger if aspirating joint)
-
Corticosteroid options
- Betamethasone (Celestone) 1 ml of 6 mg/ml
- Methylprednisolone (Solu-Medrol): 1 ml of 40 mg/ml
-
Anesthetic
- Lidocaine 1%: 3 to 5 ml or
- Bupivacaine 0.25% or 0.5%: 3 to 5 ml
V. Technique
- Images
- Patient position
- Supine with relaxed ankle
- Landmarks
- Medial aspect of talus-tibia articulation
- Palpate between anterior and posterior landmarks
- Anterior: Tibialis anterior tendon medial border
- Posterior: Medial malleolus anterior border
- Mark needle insertion site based on landmarks
- Sterilize local skin with Betadine or Hibiclens
- Insert needle at medial ankle landmark
- Direct needle posterolaterally
- Patient lies supine for several minutes after procedure
- Distribute with passive foot range of motion
VI. Follow-up Instructions
- No stress to foot for 2 weeks after injection
- Minimum time to strenuous activity: 48 hours
- Examine again in 3 weeks post-injection
VII. References
- Greene (2001) Musculoskeletal Care, AAOS, p. 429-30
- Tallia (2003) Am Fam Physician 68(7):1356-62 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Therapeutic or Preventive Procedure (T061) |
| SnomedCT | 69073003, 34333007 |
| CPT | 20605 |
| English | injection of ankle joint, injection of ankle joint (treatment), injection in an ankle joint, Injection of ankle (procedure), Injection of ankle joint, Injection of ankle, Injection of joint of ankle (procedure), Injection of joint of ankle, Injection of ankle, NOS, Injection of joint of ankle, NOS |
| Spanish | inyección en el tobillo, inyección en el tobillo (concepto no activo), inyección en la articulación del tobillo (procedimiento), inyección en la articulación del tobillo |
