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When Is an Intra-Articular Methylene Blue Injection Used?

What is an intra-articular methylene blue injection?

Intra-articular Methylene Blue Injection
Indications for an intra-articular methylene blue injection include soft-tissue injury associated with fractures in and around the joint and injuries with a visible joint capsule.

An intra-articular injection of methylene blue is a procedure performed to diagnose disruption of the joint capsule and help in early treatment.

In the open injuries of the joint, the skin and the soft tissue may penetrate the joint space. The extent of this damage can be verified by intra-articular methylene blue injection. The accuracy of the test ranges from 31% to 99%. 

Like open fractures, open joint injuries require timely diagnosis and treatment to prevent or minimize long-term morbidity and mortality.

When is an intra-articular methylene blue Injection used?

Indications for an intra-articular methylene blue injection include soft-tissue injury associated with fractures in and around the joint and injuries with a visible joint capsule.

How is an intra-methylene blue injection performed?

Anesthesia

  • The procedure is performed under local anesthesia, as it is a painful procedure.

The procedure

  • The methylene blue is injected into the joint with an appropriate syringe. If the dye seeps through the wound site, it is highly likely it’s an open joint injury. An open joint injury may be present in the absence of dye leak; hence, an orthopedic consultation is recommended for all patients.

After the procedure

  • A positive test from an open joint injury requires immediate administration of intravenous (IV) antibiotics and an emergency orthopedic evaluation for further exploration.

What are the complications of an intra-articular methylene blue injection?

Potential complications of an intra-articular injection of methylene blue, as with any invasive diagnostic procedure, include:

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Reviewed on 7/7/2020
References
Medscape Medical Reference
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