Ultrasound-Guided Injections for Elbow Pain

Abstract

Chronic elbow pain can be caused by lateral and medial epicondylosis, common extensor and flexor tendinopathy, and osteoarthritis of the radio-humeral and humero-ulnar joints. Ultrasound-guided injections and tenotomies can be an effective option when conservative treatments, including activity modifications and physical therapy, have been tried and failed. When injecting tendons the placement of the needle should be checked in two planes to ensure injectate spreads where intended. When injecting the common flexor tendon and the medial epicondyle, the position of the ulnar nerve should be checked to ensure that it is not subluxed. When injecting the common extensor tendon, one must be aware that the radial collateral ligament is located just underneath. If using steroids, one should use the lowest possible doses and volumes to minimize the possibility of weakening of the tendons, ligaments, and cartilage.