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Tarsometatarsal joint communication during fluoroscopy-guided therapeutic joint injections and relationship with patient age and degree of osteoarthritis

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Abstract

Objective

Although the tarsometatarsal joints are separated into three distinct synovial compartments, communications between adjacent compartments are often noted during image-guided injections. This study aims to determine whether abnormal inter-compartment tarsometatarsal joint communication is associated with patient age or degree of tarsometatarsal osteoarthritis.

Materials and methods

One hundred forty tarsometatarsal injections were retrospectively reviewed by two radiologists. Extent of inter-compartment communication and degree of osteoarthritis were independently scored. Univariate and multivariable analyses were performed to assess whether the presence of and number of abnormal joint communications were related to age and degree of osteoarthritis.

Results

Forty out of 140 tarsometatarsal joints showed abnormal communication with a separate synovial compartment, and 3 of the 40 showed abnormal communication with two separate compartments. On univariate analysis, higher grade osteoarthritis (p < 0.001) and older age (p = 0.014) were associated with an increased likelihood of abnormal inter-compartment tarsometatarsal communication and a greater number of these abnormal communications. On multivariate analysis, the degree of osteoarthritis remained a significant predictor of the presence of (p < 0.001) and number of (p < 0.001) abnormal communications, while the association of age was not statistically significant. There was significant correlation between age and degree of osteoarthritis (p < 0.001).

Conclusion

Higher grade osteoarthritis increases the likelihood of abnormal inter-compartment tarsometatarsal joint communication and is associated with a greater number of abnormal communications. Diagnostic injection to localize a symptomatic tarsometatarsal joint may be less reliable in the setting of advanced osteoarthritis.

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Author information

Author notes

  1. Shrita Smith

    Present address: Coordinated Health, Allentown, PA, 18104, USA

  2. Jayme C. Burket

    Present address: Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA, 94063, USA

Authors and Affiliations

  1. Radiology and Imaging, Hospital for Special Surgery, New York, NY, 10021, USA

    Yoshimi Endo, O. Kenechi Nwawka & Shrita Smith

  2. Healthcare Research Institute, Hospital for Special Surgery, New York, NY, 10021, USA

    Jayme C. Burket

Authors
  1. Yoshimi Endo
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  2. O. Kenechi Nwawka
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  3. Shrita Smith
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  4. Jayme C. Burket
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Corresponding author

Correspondence to Yoshimi Endo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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All authors state that they have no conflict of interest.

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Endo, Y., Nwawka, O.K., Smith, S. et al. Tarsometatarsal joint communication during fluoroscopy-guided therapeutic joint injections and relationship with patient age and degree of osteoarthritis. Skeletal Radiol 47, 271–277 (2018). https://doi.org/10.1007/s00256-017-2806-3

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  • DOI: https://doi.org/10.1007/s00256-017-2806-3

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