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OBJECTIVE: To investigate whether carpometacarpal (CMC) injections can be performed accurately in the office setting in patients with moderate to severe CMC osteoarthritis (OA). METHODS: Patients were recruited from rheumatology and hand surgical practices as part of an open label trial of hylan G-F 20 for CMC OA. CMC injections were performed without radiologic guidance, using anatomic landmarks to guide needle placement. Once injected, the patient was immediately taken to an adjacent ultrasound suite, and the injected CMC joint examined for evidence of intraarticular material and air microbubbles. RESULTS: Thirty-two patients were injected. All patients had ultrasound evidence of intraarticular material: 91% also had evidence of microbubbles in the joint. CONCLUSION: CMC injections can be performed accurately in the office setting, without the need for radiologic guidance, in patients with moderate to severe CMC OA.