Intra-articular injection of long acting corticosteroid is a corner stone in rheumatological treatment. The injected intra-articular corticoid is more effective when correctly placed.1 ,2 Injection of radiographic contrast material has shown that fewer than half of the injections are correctly placed in the joint space after blind injection.1

Generally, the clinical application of ultrasonographic examinations can be enhanced by contrast agents.3 The most commonly used technique is creation of microbubble contrast agents. Such agents, applied to the bloodstream, have been used for hepatic, nephrologic, cardiologic, and transcranial examinations.4 Obviously, the risk of air embolism depends on the anatomical site of the injected air …