Diagnostic and Therapeutic Injection of the Elbow RegionOct 16, Author: Corticosteroid injections and infiltrations carry minimal risk to the patient when properly indicated and performed. Technical difficulties vary; some injection and infiltration procedures require specialized knowledge for optimal results. Follow sterile precautions throughout the procedure. Clean the skin carefully with antiseptic agents.
Medial Epicondyle Injection Technique: Injection At Medial Epicondyle, Complications
Oct 16, Author: Corticosteroid injections and infiltrations carry minimal risk to the patient when properly indicated and performed. Technical difficulties vary; some injection and infiltration procedures require specialized knowledge for optimal results. Follow sterile precautions throughout the procedure. Clean the skin carefully with antiseptic agents. Ethyl chloride may be applied to the skin for anesthesia.
See the image and video below. Inject at the most tender point. Avoid injecting too superficially. Infiltrate the corticosteroid deeply at the tenoperiosteal junction. Always inject the corticosteroid at the tissue plane between the subcutaneous fat and the tendon.
At the end of the injection, withdraw the needle swiftly, and apply light pressure over the needle site. The needle should move freely with skin traction if the tip is above the tendon; conversely, the needle sticks in place if the tip is within the body of the tendon. Surprisingly few complications arise as results of these procedures. Care must always be taken to use sterile no-touch techniques. The estimated risk of septic arthritis following a corticosteroid injection is on the order of 1 per 15, procedures.
Patients with severe immunodeficiency or implants may be at greater risk of complications. The best-described complication is tendon rupture following corticosteroid injections for tendinitis. The risk of this complication can be minimized by avoiding injection into the tendon itself. No therapeutic agent should be injected against any unexpected resistance.
Other complications can arise from misplaced injections. Repeated corticosteroid infiltrations may result in chronic pain. Superficial corticosteroid infiltrations often cause a hypopigmented patch, which may be quite disfiguring in people with dark skin.
The condition resolves in a few months to 2 years. Rarely, corticosteroid injections can cause transient pituitary inhibition that may last as long as several days. Current concepts of elbow-joint disorders and their treatment. J Am Acad Orthop Surg.
Arthrocentesis and injection of joints and soft tissues. Kelley's Textbook of Rheumatology. Prevalence and determinants of lateral and medial epicondylitis: Baseball and softball injuries. Curr Sports Med Rep.
Immunohistochemical evidence of local production of catecholamines in cells of the muscle origins at the lateral and medial humeral epicondyles: Br J Sports Med. Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: Efficacy of platelet-rich plasma injections for chronic medial epicondylitis. J Hand Surg Eur Vol. A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis tennis elbow.
Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis. Epicondylar injury in sport: Dooley P, Martin R. Corticosteroid injections and arthrocentesis. Diagnostic and therapeutic injection of the elbow region. Patient-related risk factors for requiring surgical intervention following a failed injection for the treatment of medial and lateral epicondylitis. Vinod AV, Ross G. An effective approach to diagnosis and surgical repair of refractory medial epicondylitis.
J Shoulder Elbow Surg. The authors and editors of Medscape Reference gratefully acknowledge the assistance of Lars Grimm with the literature review and referencing for this article.
Sign Up It's Free! If you log out, you will be required to enter your username and password the next time you visit. Share Email Print Feedback Close. Sections Medial Epicondyle Injection. Complications Surprisingly few complications arise as results of these procedures. A year-old woman with a long history of medial epicondylitis in whom several previous cortisone injections have failed.
A multipuncture technique with attempted percutaneous tenotomy is performed to hopefully stimulate a healing inflammatory response. What would you like to print? Print this section Print the entire contents of. This website also contains material copyrighted by 3rd parties.