Lateral approach - aspiration or injection of the knee joint

Lateral approach to injection of the knee joint

Based on contributions from Dr Elspeth Wise and Dr Alan Walker on behalf of the Primary Care Rheumatology and Musculoskeletal Medicine Society

• the patient should be resting on a couch with their knee extended. Identify the superior and the inferior pole of the patella
  
  
• the space between the patella and the femoro-tibial articulation should be palpated
  
  
• the needle is inserted in line with the junction of the upper and middle thirds of the patella
  
  
• tt may be helpful to apply pressure to the medial aspect of the patella whilst injecting so as to tilt the patella medially and open up the lateral space
  
  
• the needle is directed medially and slightly posteriorly so that it is parallel with the posterior surface of the patella

Lateral injection of the knee joint - surface anatomy:

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Lateral injection of the knee joint - vastus lateralis (VL) in place:

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Lateral injection of the knee - vastus lateralis (VL) removed for explanatory purposes to show injection point

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Key to acronyms:

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Reference:

• Primary Care Rheumatology Society (PCRS). Joint and soft tissue Injection guidelines PCRS (Updated 2017)