Sonographically Guided Distal Biceps Tendon Injections

Sellon, Jacob L.; Wempe, Michael K.; Smith, Jay

doi:10.7863/ultra.33.8.1461

Cited by 12 publications

(7 citation statements)

References 27 publications

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“…Specifically, with the anterior approach the operator must safely navigate around the brachial artery, median nerve, and lateral antebrachial cutaneous nerve, all of which lie in close proximity to the biceps tendon in that view (Figure 4). This concern has been demonstrated in the aforementioned cadaver study in which the experienced sonographer [8] noted a brachial artery injury when experimenting with an anterior injection approach to this area. By using the technique we describe in this report, these neurovascular structures are avoided.…”

Section: Discussionmentioning

confidence: 90%

“…To our knowledge, use of the US-guided approach with a live subject has not previously been described in the literature; however, this approach has been studied in cadavers [8]. In that study the authors injected 18 unembalmed cadaveric elbows from different approaches, which included an in-plane posterior approach similar to the technique we described.…”

Section: Discussionmentioning

confidence: 99%

“…In that study the authors injected 18 unembalmed cadaveric elbows from different approaches, which included an in-plane posterior approach similar to the technique we described. The investigators concluded that posterior injection in this region could be accomplished with good accuracy and relative ease of use [8].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound‐Guided Distal Bicep Tendon Injection Using a Posterior Approach

Mautner

Stafford

Nguyen

2015

PM&R

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Distal biceps tendinopathy is an uncommon but increasingly diagnosed condition in persons with elbow pain. When traditional treatments are unsuccessful, practitioners have performed ultrasound (US)-guided tendon injections in this region using an anterior approach. Although success has been reported with this technique, this approach may lead to neurovascular injury. This case report is the first in the literature to describe a US-guided distal bicep tendon injection using a posterior approach. The patient had an excellent clinical outcome with no adverse events. This outcome suggests that a US-guided posterior percutaneous tendon injection might be a safe, viable, nonsurgical option for recalcitrant distal biceps tendinopathy.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Ultrasound‐Guided Distal Bicep Tendon Injection Using a Posterior Approach

Mautner

Stafford

Nguyen

2015

PM&R

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“…There are several viable options described for infiltration with ultrasound guidance. Sellon et al [1] found a high success rate for sonographically guided peritendinous and intratendinous infiltration of the distal biceps tendon through multiple approaches. All of their peritendinous injections were successful, and 94% of their intratendinous injections were successful.…”

Section: Discussionmentioning

confidence: 99%

“…proaches available for infiltration around the biceps tendon [1]. Some perform the injection manually without ultrasound guidance; others use ultrasound guidance to determine the location of the tip of the needle.…”

mentioning

confidence: 99%

Distal biceps tendon injection

Vis¹,

Janssen²,

Bleys³

et al. 2021

Clin Shoulder Elbow

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Background: Injection therapy around the distal biceps tendon insertion is challenging. This therapy may be indicated in patients with a partial distal biceps tendon tear, bicipitoradial bursitis and tendinopathy. The primary goal of this study was to determine the accuracy of manually performed injections without ultrasound guidance around the biceps tendon.Methods: Seven upper limb specialists, two general orthopedic specialists and three orthopedic surgical residents manually injected a cadaver elbow with acrylic dye using an anterior and a lateral infiltration approach. After infiltration the cadaveric elbows were dissected to determine the location of the acrylic dye.Results: In total, 79% of the injections were localized near the biceps tendon. Of these injections, 20% were localized on the radius near the bicipitoradial bursa. In total, 53% of the performed infiltrations were injected by anterior and 47% by lateral approaches. Of the injections near the distal biceps (79%), 47% were injected by an anterior and 53% by a lateral approach. Of the injections on the radius (20%), 33% were injected by anterior and 67% by lateral approach. Of the inaccurate injections (21%), 75% were injected anterior and 25% lateral. Conclusion: Manual infiltration without ultrasound guidance for distal biceps pathology lacks accuracy. We therefore recommend ultrasound guidance for more accurate infiltration.

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