Comparison of ultrasound (US)-guided intra-articular injections by in-plain and out-of-plain on medial portal of the knee

Rheumatol Int. 2013 Aug;33(8):1951-9. doi: 10.1007/s00296-012-2660-5. Epub 2013 Jan 25.


To compare the accuracy rates between ultrasound (US)-guided in-plain (IP), out-of-plain (OOP) and blind knee intra-articular (IA) injection via the mid-medial portal. US-guided IA injection in the IP, OOP, and blind methods was performed on 126 knees with radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) without effusion. About 6 ml of a mixed material containing 1% lidocaine (1 mL) and triamcinolone 20 mg (1 mL) and nonionic contrast (4 mL) was injected into the IA space of the knee through the mid-medial portals. After an US-guided and blind IA injection into the knee joint, a radiographic image was taken to determine whether the injected material had reached the IA space or infiltrated into the soft tissue. US-guided IA injections in the IP (97%; P < 0.05) and OOP method (95%; P < 0.05) showed significantly higher accuracy rate than injections in the blind injection (78%). Both US-guided IA injection methods may be used to access the knee joint with high degree of accuracy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Drug Therapy, Combination
  • Female
  • Humans
  • Injections, Intra-Articular
  • Knee Joint / diagnostic imaging*
  • Lidocaine / administration & dosage
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / drug therapy*
  • Radiography
  • Single-Blind Method
  • Treatment Outcome
  • Triamcinolone / administration & dosage
  • Triamcinolone / therapeutic use*
  • Ultrasonography


  • Triamcinolone
  • Lidocaine