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Many patients present to the emergency department for ankle swelling. On way to identify signs of intra-articular swelling is to use POCUS. To perform this, place the linear probe at the tibio-talar junction with the probe marker placed towards the patient’s head. An effusion is identified as anechoic fluid in-between the tibia and talus bone.
POCUS has been shown to improve first-pass success and overall success as compared to a landmark based approach for medium-sized joints. When performing an ankle arthrocentesis with POCUS, care should be taken to avoid blood vessels and tendons.
References
Gibbons RC, Zanaboni A, et al. Ultrasound-versus landmark-guided medium-sized joint arthrocentesis: A randomized clinical trial. Acad Emerg Med. 2022 Feb;29(2):159-163. doi: 10.1111/acem.14396.