 The risks (including, but not limited to, those of bleeding, infection, allergic reaction, inability to access the joint, and failure of medication to relieve pain) and benefits of the procedure were explained to the patient, and informed written consent was obtained. A pre-procedural “time-out” form was completed.The patient was placed supine on the fluoroscopy table. The right wrist was localized fluoroscopically, and a spot radiograph was obtained. The skin was cleansed and covered with a sterile drape. The skin and subcutaneous tissues were anesthetized with 1% lidocaine using 25-gauge.Under fluoroscopic guidance, 22 gauge needle was advanced into the joint in the mid carpal compartment. Next, 7 mL of a 50/50 mixture of Omnipaque 240 (to confirm the intra-articular position of the needle) and dilute Multihance (0.1 cc in a 10 cc vial of saline, for subsequent MR imaging) were injected into the joint. Contrast opacified the joint in the expected manner. A spot radiograph was obtained for documentation. The needle was withdrawn. Both ulnar deviation and radial deviation spot images were obtained without apparent extravasation of contrast into the radiocarpal compartment.Blood loss was negligible (<1cc), and the patient tolerated the procedure well without immediate complication. An adhesive bandage was placed on the patient’s skin. Routine post procedure instructions were communicated to the patient. The patient was escorted to the MRI suite for further imaging in stable condition. Please refer to the subsequent MRI report for further information. Exposure time: 1:35 minutes
Successful fluoroscopically guided injection of contrast into the midcarpal compartment of the right wrist. Please refer to the subsequent MRI report for further information. 