Tallia Alfred F, Cardone Dennis A
Department of Family Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA.
Am Fam Physician. 2003 Oct 1;68(7):1356-62.
Joint and soft tissue injection of the ankle and foot region is a useful diagnostic and therapeutic tool for the family physician. This article reviews the injection procedure for the plantar fascia, ankle joint, tarsal tunnel, interdigital space, and first metatarsophalangeal joint. Indications for plantar fascia injection include degeneration secondary to repetitive use and traumatic injuries that are unresponsive to conservative treatment. Diagnostic aspiration or therapeutic injection of the ankle or first metatarsophalangeal joints can be performed for management of advanced osteoarthritis, rheumatoid arthritis, and other inflammatory arthritides such as gout, or synovitis or an arthrosis such as "turf toe." Persistent pain and disability resulting from tarsal tunnel syndrome, an analog of carpal tunnel syndrome of the wrist respond to local injection therapy. A painful interdigital space, such as that occurring in patients with Morton's neuroma, is commonly relieved with corticosteroid injection. The proper technique, choice and quantity of pharmaceuticals, and appropriate follow-up are essential for effective outcomes.
踝关节和足部区域的关节及软组织注射对家庭医生来说是一种有用的诊断和治疗工具。本文回顾了跖腱膜、踝关节、跗管、趾间间隙和第一跖趾关节的注射方法。跖腱膜注射的适应证包括因反复使用继发的退变以及对保守治疗无反应的创伤性损伤。对于晚期骨关节炎、类风湿关节炎和其他炎性关节炎（如痛风）或滑膜炎或诸如“草皮趾”的关节病，可对踝关节或第一跖趾关节进行诊断性抽吸或治疗性注射。跗管综合征（类似于腕部的腕管综合征）导致的持续疼痛和功能障碍可通过局部注射治疗得到缓解。疼痛的趾间间隙，如莫顿神经瘤患者出现的情况，通常通过皮质类固醇注射得到缓解。正确的技术、药物的选择和用量以及适当的随访对于取得有效结果至关重要。
