Syringe

As a physician assistant practicing in orthopaedics, one of the skills that can set you apart from many others is to become really good at injections.  Injections and/or aspirations are procedures done on a daily basis in clinic for the treatment or diagnosis of a condition, whether it be a knee, shoulder, ankle, soft tissue, etc..

There are many conditions that can benefit from injection therapy, which can include cortisone, hyaluronic acid, platelet rich plasma, or anesthetic injections, therefore there is plenty of opportunity to perform the skill.  Several techniques exist for all types of injections, and I have used several different techniques for the same injection. Intra-articular knee injections for instance, I use superior lateral or medial patella injections and anterior lateral or medial joint line injections and they all go to the same place.  What determines which technique I use?  Well, my "go to" method is superior lateral because I find that patients relax and tolerate it better, that was the technique I was taught by an early mentor, and several papers that I have read over the years show it to have the highest intra-articular success rate. That being said I'll chose to use another technique if anatomy or the situation calls for it.  Another determining factor, as to which technique to use, is simply the one that you are most comfortable doing.  Whichever one that is, is the one that will have the highest chance of success for you and comfort for the patient.

Again, I will explain each technique as I do to students in the labs that I teach and precept.

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Shoulder

Elbow

Wrist

Hand

Hip

Knee

Ankle

Foot