The wrist, a complex joint, often is involved in inflammatoryarthritis, such as rheumatoid arthritis or psoriatic arthritis. Wristsynovitis causes pain, swelling, and loss of extension. Extension of thesynovial lining may lead to synovitis of the ulnar styloid. During injectionof the ulnocarpal joint, the lidocaine and corticosteroid mixtureshould flow without resistance. Injecting air after corticosteroidinjection of the ulnar styloid creates a seal that prevents the corticosteroidfrom leaking up the needle tract into the dermal layer and creatingunsightly depigmentation. (J Musculoskel Med. 2008;25:188-189)
For both injections, the patient lies supine or sits upright. The arm is extended and the palm is in a pronated position comfortably supported on a pillow or towel roll with the wrist in mild flexion.
Radiocarpal joint injection in a patient's right wrist is shown in this photograph.
A lateral approach to left ulnar styloid (ulnocarpal joint) injection is shown here.