Background and indications: Lateral and medial epicondylitis is the most common reason for chronic elbow pain. Other causes, such as joint synovitis or arthritis, are also possible. These patients may benefit from an intra-articular corticosteroid injection. A simplistic method for performing an intra-articular injection of the elbow is to place the needle between the radial head and the capitulum, which is easily visualized under ultrasound. The use of musculoskeletal ultrasound can be utilized to detect joint synovitis when applying color Doppler as well as to detect fluid, septic effusion, etc.

Anatomy: The joint capsule invests the entire elbow joint. Inferiorly, it is attached to the humeral shaft just above the coronoid and radial fossae, to the anterior aspect of the coronoid process and to the annular ligament. Because of this anatomical relationship, intra-articular injections of the elbow joint can be accomplished by injecting the radial capitulum articulation, which will then communicate to the rest of the intra-articular space of the elbow. This is the preferable approach for intra-articular injections of the elbow (Fig. 64.1).

Transducer: Small 25-mm linear transducer.

Transducer orientation: Longitudinal in a line with the radius.

Needle: 25G to 27G, 1-inch to 1.5-inch

Local anesthetic: 2 mL of local anesthetic with 40 mg of triamcinolone.

Patient position: Sitting or lateral decubitus with the elbow bent at 90 degrees.

Technique:

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