Ruiz Santiago Fernando, Moraleda Cabrera Beatriz, Láinez Ramos-Bossini Antonio Jesús
Department of Radiology and Physical Medicine, Faculty of Medicine, University of Granada, 18071, Granada, Spain.
Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain.
J Ultrasound. 2024 Mar;27(1):153-159. doi: 10.1007/s40477-023-00808-1. Epub 2023 Jul 30.
Ultrasound guidance is particularly useful for percutaneous injections in the diagnosis and management of painful conditions of the ankle and foot. The injectates used include steroids and local anesthetics, such as lidocaine, mepivacaine, bupivacaine, ropivacaine, and platelet-rich plasma. Osteoarthritis is the main indication for joint injections. Joints amenable to being injected include the tibiotalar, subtalar, midtarsal, and metatarsophalangeal joints. Tendon injections mainly involve the Achilles, peroneus, extensors, and tibialis tendons, while plantar fascia injections are useful for treating plantar fasciitis and plantar fibromatosis. Forefoot injections include joint arthritis, intermetatarsal bursitis, and Morton neuroma. The standardized approaches and doses reviewed in this paper are based on the authors' experience and can lead to high success in symptomatic relief for various conditions. These injections can be curative or serve as a guide to identify the source of pain when surgery or other therapeutic options are planned.
超声引导对于踝关节和足部疼痛性疾病的诊断和治疗中的经皮注射特别有用。所使用的注射剂包括类固醇和局部麻醉剂，如利多卡因、甲哌卡因、布比卡因、罗哌卡因和富血小板血浆。骨关节炎是关节注射的主要适应症。适合注射的关节包括胫距关节、距下关节、中跗关节和跖趾关节。肌腱注射主要涉及跟腱、腓骨肌腱、伸肌腱和胫骨肌腱，而足底筋膜注射对于治疗足底筋膜炎和足底纤维瘤病很有用。前足注射包括关节关节炎、跖间滑囊炎和莫顿神经瘤。本文所回顾的标准化方法和剂量基于作者的经验，对于各种病症的症状缓解可取得很高的成功率。这些注射可以治愈疾病，或者在计划进行手术或其他治疗选择时作为确定疼痛来源的指南。
