Objective To describe a posterolateral fluoroscopy-guided
injection technique into the posterior subtalar joint and to
report patient outcomes 1 month post-injection.
Materials and methods Twenty-three consecutive adult
patients who underwent fluoroscopy-guided injection into
the posterior subtalar joint using a direct posterolateral
approach and who returned an outcomes-based postal
questionnaire after receiving this injection were included.
Numerical pain rating scale (NRS) data were collected prior
to injection. NRS and Patient’s Global Impression of
Change (PGIC) scales were completed 1 day, 1 week, and
1 month after injection. The proportion of patients who
improved was calculated for each time period. Baseline
NRS data were compared to each time point using the
Wilcoxon test to assess differences. Spearman’s correlation
coefficient was used to compare the 20 min NRS score with
all follow-up NRS scores. All available images were
reviewed for the presence of subtalar osteoarthritis (OA).
Patient charts were reviewed to identify characteristics of
patients referred for subtalar injections. Risk ratios were
calculated comparing presence of OA or other abnormalities
Results A posterolateral approach for fluoroscopy-guided
injections into the subtalar joint is described. There was a
significant reduction in the mean NRS score at all time
periods compared to baseline (p ≤ 0.004). One-third of
patients (7/21) reported clinically relevant improvement at
Conclusions Fluoroscopy-guided puncture of the posterior
subtalar joint using a posterolateral approach is possible.
Clinically significant improvement is reported in 33% of
patients after 1 month.