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Musculoskeletal and Sports Medicine

Ultrasound-Guided Hyaluronic Acid Injections for Radiocarpal Joint Osteoarthritis: A Case Report

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 2

    Primary Author(s)

  • Antonio Casco-Zuleta, MD

    Resdident Physician
    UCLA David Geffen SOM/ UCLA Medical Center/VA Greater Los Angeles Health
    Los Angeles, California

    • Poster Presenter(s)

  • Catherine Y. Cho, DO (she/her/hers)

    Resident Physician
    UCLA David Geffen SOM/ UCLA Medical Center/VA Greater Los Angeles Health
    Los Angeles, California

    • Co-Author(s)

  • EW

    Eric Watson, DO

    Physiatrist
    Ventura County Med Center
    Ventura, California

Disclosure(s):
Antonio Casco-Zuleta, MD: No financial relationships to disclose
Catherine Cho, DO: No financial relationships to disclose
Case Diagnosis: A 46-year-old male with a history of right scaphoid fracture and moderate radiocarpal joint osteoarthritis with symptomatic and functional improvement following hyaluronic acid injections.

Case Description or Program Description: Patient with a history of a comminuted right scaphoid fracture from a ground-level fall (~20 years ago), now presenting with right wrist pain and decreased range of motion in all planes. Denied numbness, tingling, or weakness. Imaging showed hardware in the scaphoid with bone deformity and moderate osteoarthritis of the radiocarpal joint. Traditional treatments, including physical therapy, oral/topical anti-inflammatory medications, and corticosteroid injections, failed to provide relief. Given this, ultrasound-guided hyaluronic acid injections (HAI) to the right radiocarpal joint were trialed.

Setting: Outpatient Physical Medicine and Rehabilitation Clinic

Assessment/Results: At six-week follow-up, post-HAI #1, the patient reported significant pain relief, with mild recurrence at five weeks. He subsequently received HAI #2. At a two-month follow-up from the second injection (3.5 months post-initial injection), the patient noted improved pain, and range of motion, and did not receive an additional injection. At six months from the initial injection, the patient reported continued benefit and received HAI #3 with plans for reassessment in six months.

Discussion (relevance): Traditional treatments for wrist osteoarthritis include oral/topical analgesics and corticosteroid injections. Given their failure in this patient, HAI was trialed, yielding significant symptomatic improvement (pain) after one injection and additional functional improvement (range of motion) after two injections. A third injection was also performed, though symptoms at that time were minimal. While HAI is well-documented for trapeziometacarpal arthritis, no prior literature supports its use in radiocarpal joint osteoarthritis. The positive outcome in this case suggests a need for further investigation.

Conclusions: Hyaluronic acid injections may be a viable alternative for managing pain and range of motion limitations in radiocarpal joint osteoarthritis. However, additional research is needed to establish its efficacy compared to conventional treatments.