REASONS FOR PERFORMING STUDY: Injection of the navicular bursa is commonly performed from the palmar aspect of the limb, which results in penetration of the @entity427 ( @entity427 ). OBJECTIVES: To report a radiographic guided injection from the lateral aspect of the limb that avoids puncture of the @entity427 and to assess synovial and soft tissue penetration by the needle. STUDY DESIGN: Prospective clinical and cadaveric study. METHODS: Prospective analysis of cadaver limbs and clinical cases in which the navicular bursa was injected from the lateral aspect. Cadaver limbs were placed in a stand to simulate weight bearing and injection was performed in limbs without @entity12897 or with distension of either the @entity571 ( @entity571 ) joint, @entity1795 ( @entity1795 ) or navicular bursa. In cadaver and clinical limbs, contrast was injected and the needle position assessed with radiographs. Cadaver (but not clinical) limbs were also examined using magnetic resonance imaging with the needle in situ. RESULTS: Successful navicular bursal injection was achieved in all limbs (n = 71). Relative risk of @entity571 joint puncture was 19 times higher (95% confidence interval 1.3-285.4, P<0.001) when the @entity571 joint was distended (9 of 10 limbs) than in normal limbs (0 of 10 limbs). Relative risk of @entity1795 puncture was 2.7 times higher (95% confidence interval 1.0-7.2, P = 0.06) when the @entity1795 was distended (8 of 10 limbs) than in normal limbs (3 of 7 limbs). Synovial fluid was aspirated from 47% of bursae from clinical cases. CONCLUSIONS: The lateral injection technique for the navicular bursa avoids penetration of the @entity427 , although risk of synovial penetration must be considered when there is potential @entity571 joint or @entity1795 infection.

An optimised injection technique for the navicular bursa that avoids the XXXX .

@entity12897 :: ('MESH:D013581', 'Disease') :: ['synovial distension'] @entity427 :: ('MESH:D012021', 'Disease') :: ['DDFT', 'deep digital flexor tendon'] @entity571 :: ('MESH:D010003', 'Disease') :: ['DIP', 'distal interphalangeal'] @entity1795 :: ('MESH:D052582', 'Disease') :: ['digital flexor tendon sheath', 'DFTS']
@entity427 :: (MESH:D012021,Disease) :: ['deep digital flexor tendon']
