Intraarticular extravasation following intraosseous needle intravenous access

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Off label use of intraosseous needles (IONs) for contrast media (CM) injection during computed tomographic angiography (CTA) has been reported in small case series and isolated case reports” Winkler et al (2018).

Abstract:

Off label use of intraosseous needles (IONs) for contrast media (CM) injection during computed tomographic angiography (CTA) has been reported in small case series and isolated case reports. Presently, complications specific to this novel indication are essentially unknown. In this communication, we report an extravasation of CM from the intramedullary space of the humerus into the glenohumeral joint space during an ION injection of CM during a CTA of the head, neck, and chest. Although clinically insignificant in this case, a more severe intraarticular extravasation could have had both short or long term adverse sequelae. Practitioners of CTA should be aware of this potential complication.

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References:
Winkler, M., Issa, M., Lowry, C., Chornenkyy, Y. and Sorrell, V. (2018) Intraarticular extravasation, an unusual complication of computed tomographic angiography performed with intraosseous needle intravenous access. Cardiovascular Diagnosis and Therapy. 8(4), p.516-519.

doi: 10.21037/cdt.2018.06.04.

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