Great summary. Went in search of a neat description of how to aspirate a MTP joint and found a few out of focus Youtube videos. I have to admit I am not always successful in getting into the joint. It hurts and I don’t like hurting my patients. Maybe something for the future, although I know which side of the camera I would be on.
Did find a couple of written resources which I thought maybe useful.
http://www.aafp.org/afp/2003/1001/p1356.html – Diagnostic and Therapeutic Injection of the Ankle and Foot. The American Academy of Family Physicians often has nice articles in it.
I only have one tip. If you have an US machine – use it! I use it to measure the size of the effusion, map out the needle track – depth to effusion, deepest point, structures to miss and create a mental map.
Then I do it without US guidance – though you can do it under direct US vision.
I think I have fewer dry taps, less pain, rarely more than one pass of the needle
FOAM4GP 
Great summary. Went in search of a neat description of how to aspirate a MTP joint and found a few out of focus Youtube videos. I have to admit I am not always successful in getting into the joint. It hurts and I don’t like hurting my patients. Maybe something for the future, although I know which side of the camera I would be on.
Did find a couple of written resources which I thought maybe useful.
http://www.uth.tmc.edu/schools/med/imed/residency/chiefscorner/Documents/procedures/Arthrocentesis.pdf – which seems to be scanned from someone test book by University of Texas
http://www.aafp.org/afp/2003/1001/p1356.html – Diagnostic and Therapeutic Injection of the Ankle and Foot. The American Academy of Family Physicians often has nice articles in it.
I only have one tip. If you have an US machine – use it! I use it to measure the size of the effusion, map out the needle track – depth to effusion, deepest point, structures to miss and create a mental map.
Then I do it without US guidance – though you can do it under direct US vision.
I think I have fewer dry taps, less pain, rarely more than one pass of the needle
Casey
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