Thumb Injection Periprocedural Care

Updated: Sep 03, 2019
  • Author: Charlene Kiang, MD; Chief Editor: Erik D Schraga, MD  more...
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Periprocedural Care

Equipment

Equipment used for thumb injection includes the following:

  • Syringe, 3 mL
  • Needle, 1 in. (2.5 cm), for drawing up into the syringe
  • Needle, 27 gauge, 0.5 in. (1.25 cm), for injection
  • Sterile examination gloves
  • Povidone-iodine skin preparation with sterile gauze
  • Corticosteroid, 1-2 mL (eg, triamcinolone acetonide or methylprednisolone acetate; see the image below)
Thumb injection: equipment (corticosteroid, anesth Thumb injection: equipment (corticosteroid, anesthetic).
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Patient Preparation

Anesthesia

Local anesthetic agents (eg, bupivacaine 0.5% or lidocaine 1%) may be used. The local anesthetic can be mixed with the corticosteroid.

Positioning

For proper positioning, identify the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons by having the patient extend the thumb (see the image below). Mark the gap between the tendons, distal to the radial styloid. Place the patient's hand vertically with the radial side up in a relaxed position.

First dorsal compartment of hand, including abduct First dorsal compartment of hand, including abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons.
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