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Palpation-Guided Intra-articular Injection of the First Metatarsophalangeal Joint: Injection Technique and Safe Practice for Novice Practitioners

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Abstract

Injection of a glucocorticoid for the relief of vertebrogenic, arthritic and radiculopathic pain is widely accepted. Diarthrodial joints are especially well suited to intra-articular injection, and the local delivery of therapeutics in this fashion brings several potential advantages to the treatment of a wide range of arthropathies. Injectable glucocorticoids are used in the first metatarsophalangeal joint (1st MTP jt) to treat various forms of joint pathology such as osteoarthritis (hallux rigidus) and gout, but no standard protocol for injection of this joint exists. In their document ‘Promoting Safer Use of Injectable Medicines’ the National Patient Safety Agency identified a number of latent system risks and produced a series of templates for prescribing, preparing and administering injectable medicines. The two aims of this paper are to promote injection technique safety and to offer a palpation-guided 1st MTP jt injection technique, prior to further work which will be undertaken to validate injection placement accuracy.

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Acknowledgements

I wish to thank George Flanagan, Consultant Podiatric Surgeon at Northamptonshire Healthcare Foundation NHS Trust for taking the X-rays/clinical photographs, and to Professors Nachiappan Chockalingam and Roozbeh Naemi from the School of Life Sciences, Staffordshire University, for their help with the format of the manuscript.

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  1. Department of Podiatric Surgery, Northamptonshire Healthcare Foundation NHS Trust, Kettering, UK

    Ian Reilly

  2. Danetre Hospital, Daventry, Northamptonshire, NN11 4DY, UK

    Ian Reilly

  3. School of Life Sciences and Education, Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, ST4 2DF, UK

    Ian Reilly

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Reilly, I. Palpation-Guided Intra-articular Injection of the First Metatarsophalangeal Joint: Injection Technique and Safe Practice for Novice Practitioners. SN Compr. Clin. Med. 3, 136–144 (2021). https://doi.org/10.1007/s42399-020-00719-w

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