FLUOROSCOPICALLY GUIDED INJECTIONS INTO THE FOOT AND ANKLE - LOCALIZATION OF THE SOURCE OF PAIN AS A GUIDE TO TREATMENT - PROSPECTIVE-STUDY

PURPOSE: To determine the value of injections of local anesthetic and steroids in the foot and ankle in localizing the source of pain and th eir effect on clinical confidence and decision making. MATERIALS AND M ETHODS: In 47 patients, fluoroscopically guided injections of local an esthetic and steroid into the foot and ankle were performed in 106 int ra- and extraarticular sites. Questionnaires were completed by the ref erring surgeon before and after injections to evaluate the level of co nfidence with regard to the source of pain for each site injected and the proposed treatment plan. RESULTS: Forty-three (91%) patients repor ted pain relief after injections. The level of confidence that the sit e injected was the source of pain increased in 68 (64%) sites, decreas ed in 19 (18%) sites, and remained unaltered in 19 (18%) sites (P < .0 1). The treatment plan was changed from nonsurgical initially to surgi cal in three (8%) of 36 patients and was changed from surgical to nons urgical in three (27%) of II patients after injections. Of the remaini ng eight patients, treatment was altered in three (37%) as a result of pain relief after the injections. CONCLUSION Fluoroscopically guided injections of local anesthetic and steroid in the foot and ankle can i mprove clinical confidence with regard to the site of pain and may be valuable in clinical decision making and patient treatment.