Dorsal Wrist
April 2025
Peer Reviewer: Justine Ko, MD, CAQ-SM
This image was obtained using a linear probe in a longitudinal orientation along the dorsal aspect of the wrist.
A 65 year old male presents with left wrist pain. He has noted swelling to his left wrist for the past several days. You perform an ultrasound and notice an effusion. To assist with diagnosis, you opt to perform a wrist arthrocentesis. Ultrasound can be a great tool to assist with arthrocentesis.
Image 4: Case courtesy of NYSORA
How would you perform an ultrasound guided arthrocentesis of the wrist joint?
-
Place the probe in a longitudinal fashion in the dorsal radiocarpal area.
-
Identify the effusion.
-
Using an in-plane approach, guide the needle under US-guidance, aspirating as you go. Note: An out-of-plane approach can also be used
-
As you visualize the needle in the anechoic fluid, you should be getting synovial fluid return
Image 6-7: Demonstration of ultrasound-guided wrist arthrocentesis, images courtesy of NYSOR (author’s own annotations)