Functions of the Index Finger in Musculoskeletal Intervention: A Technical Note

Abstract Literature outlining the role of hand positioning in percutaneous radiological procedures is sparse. However, this is a crucial consideration in musculoskeletal intervention because of the range of needles used. Specifically, the index finger helps to optimize needle stability, trajectory, and enable controlled insertion to improve patient safety and the likelihood of procedural success. This article explores the uses of the index finger in the manipulation of devices when performing percutaneous musculoskeletal procedures. The index finger may be either fully or partially extended and anchored along the shaft of the biopsy device. When fully extended, the index finger can rest against the skin to provide counterforce during needle advancement—this prevents unintended jolted advancements when passing between tissues of different densities. When partially extended, the index finger rests on a point of reference along the needle shaft and acts as a confirmatory marker for the depth of insertion once that level is flush with the skin. The suggested index finger positions should be consistently used to promote needle stability and ensure controlled advancement.