Wrist and hand
Ultrasound-guided injection for rhizarthrosis
The joint at the base of the thumb is reached with a thin needle under ultrasound guidance, allowing precise medication delivery to reduce pain during hand movements.
How it is performed
Rhizarthrosis is osteoarthritis of the trapeziometacarpal joint, which connects the thumb to the wrist and enables gripping and pinching. After ultrasound identifies the joint profile and nearby structures, the needle is guided under direct visualisation into the joint space and a small amount of corticosteroid or, in selected cases, hyaluronic acid is injected. The procedure is performed as an outpatient treatment, takes a few minutes and requires no incision.
Who it is for
- Painful rhizarthrosis documented on radiography or ultrasound
- Pain at the base of the thumb when opening a jar, turning a key or pinching
- Lack of response to a brace, physiotherapy and medication
Recovery
You return home immediately. Avoid strenuous gripping for 24–48 hours; corticosteroid relief usually appears over the following days, while the effect of hyaluronic acid may develop more gradually.
Conditions treated in this area: thumb-base osteoarthritis (rhizarthrosis), pain when gripping and pinching, stiffness and reduced hand strength.
Scientific evidence
Randomised studies in rhizarthrosis show that both corticosteroid and hyaluronic acid can reduce pain and functional limitation, with different time profiles: corticosteroid tends to provide faster relief, while hyaluronic acid may maintain functional improvement for longer in some patients. Ultrasound makes it possible to visualise a small joint often distorted by osteoarthritis and to control needle placement; the medication and indication should be personalised according to disease stage and previous treatments.
References on PubMed
- Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study
Monfort J, Rotés-Sala D, et al. — Joint Bone Spine, 2015 · PMID 25311256
- Comparison of therapeutic effects of sodium hyaluronate and corticosteroid injections on trapeziometacarpal joint osteoarthritis
Bahadir C, Onal B, et al. — Clin Rheumatol, 2009 · PMID 19137353
- The Accuracy of Common Hand Injections With and Without Ultrasound: An Anatomical Study
To P, McClary KN, Sinclair MK, et al. — Hand (N Y), 2018 · PMID 28719974
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of ultrasound-guided injection for rhizarthrosis?
It is an outpatient procedure performed with a thin needle under local anaesthesia and continuous ultrasound guidance, which makes it possible to see the needle, the target and the structures to avoid in real time. The most common issues are transient: pain or swelling for 24-48 hours, a small bruise. Joint infection is a rare event, prevented by sterile technique. In treatments with cortisone, facial flushing or a temporary rise in blood sugar may occur in diabetic patients. Personal risks and contraindications are assessed during the consultation.
How much does the ultrasound-guided injection for rhizarthrosis cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "how long does the benefit last?" and "can I repeat it?". The answer depends on the diagnosis and the stage: some injections resolve the painful episode, others serve to open a window in which rehabilitation becomes effective. Experiences read in forums concern cases different from yours. During the consultation we review your imaging and I tell you frankly what to expect, how many sessions may be needed and when another approach is better.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.