Wrist & Hand Ultrasound Guided Injections

Ultrasound's ability to accurately image large numbers of anatomical structures, in short durations and with different joint positions makes it the perfect diagnostic tool for wrist & hand pain...

Wrist & Hand Diagnostic Ultrasound Scan

The Anatomy of a Wrist & Hand Ultrasound Scan

The wrist and hand is a complex network of small joints, tendons, tendon sheaths and a network of nerves. Wrist and hand conditions maybe due to degenerative changes, injuries or inflammation at any of these structures. Due to the complex anatomy, ultrasound is the favoured imaging modality to diagnose the majority of wrist and hand pain conditions.

Wrist and hand tendon and tendon sheath disorders (known as tenosynovitis) are extremely well evaluated using ultrasound imaging. An ultrasound scan is able to exclude any tendons tears, examine the  fine detail of the tendons fibre structure and fibre orientation as well as evaluate any inflammation and fluid within the tendon sheath. Common conditions diagnosed at the wrist and hand with ultrasound imaging include De Quervain's Tenosynovitis and Trigger Finger or Trigger Thumb.

The wrist joint and small joints of the hand and fingers commonly suffer with degenerative changes (osteoarthritis). An ultrasound scan is able to clearly image bony irregularities to the joint margins as well as identify small joint effusions and thickening to the joint soft tissue capsules all which are features of osteoarthritis.

As the forearm narrows to become the wrist and hand, blood vessels and nerves are carried within specific tunnels as they cross the wrist in to the hand. Nerve conditions such as carpal tunnel syndrome (compression of the median nerve within the carpal tunnel) or ulnar neuropathy (compression of the ulnar nerve within "guyons canal" are well visualised and diagnosed reliably with an ultrasound scan of the wrist and hand.

Types of Wrist & Hand Ultrasound Guided Injections

Wrist & Hand Joint Ultrasound Guided Injections

The wrist and hand Anatomy is complex and is composed of several bones, many joints as well as tendons and nerves which lie on both sides of the wrist and hand. Due to this complex anatomy, a wrist joint injection or a hand joint injection must be targeted at the specific area of  pain or pathology which the clinician will decide on the basis of a physical examination and ultrasound scan. Wrist and hand joint injections may target the following joint complexes:

Due to the small joint cavity of these wrist and hand joints an intra-articular corticosteroid injection is normally very effective at relieving pain and inflammation from degenerative osteoarthritis or following wrist or hand trauma. 

Wrist & Hand Tendon Sheath Ultrasound Guided Injections

Many cases of wrist and hand pain are also related to a problem with the tendon or tendon sheath known as tenosynovitis. Often a tenosynovitis of the wrist or hands may develop due to repetitive movements or overuse of this area in poor economic positions but can also develop following trauma. To reduce the swelling and pain in the tendon sheath appropriately the needle must be guided under ultrasound into the small area between the tendon and tendon sheath itself. A steroid wrist injection is normally a very effective solution for these conditions.

Carpal Tunnel Syndrome Ultrasound Guided Injections

Lastly, wrist and hand pain, especially when associated with  sensory symptoms such as numbness pins and needles or tingling may relate to an irritation or compression of one of the nerves which lie through this area. The most common neuropathy in the wrist and hand which can be targeted successfully with an ultrasound guided wrist injection is known as carpal tunnel syndrome.