Sonographically guided distal biceps tendon injections: techniques and validation.

Area of Science:

• Musculoskeletal imaging
• Interventional radiology
• Anatomy

Background:

• Distal biceps tendinopathy and bursopathy can cause significant elbow pain.
• Accurate injection placement is crucial for effective treatment.
• Sonographic guidance offers precision for injections.

Purpose of the Study:

• To describe and validate sonographically guided techniques for distal biceps peritendinous and intratendinous injections.
• To assess the feasibility and accuracy of these injection methods in a cadaveric model.

Main Methods:

• Eighteen sonographically guided peritendinous and 15 intratendinous injections were performed on 18 cadaveric elbows.
• Various anterior and posterior approaches were utilized for both peritendinous and intratendinous injections.
• Injectate placement was assessed via dissection after injection.

Main Results:

• All peritendinous injections successfully placed latex around the tendon.
• 93% of intratendinous injections accurately placed injectate within the tendon.
• Posterior intratendinous approach was easiest; one brachial artery injury occurred with an anterior/superficial peritendinous approach. No neurovascular injury with intratendinous injections.

Conclusions:

• Sonographically guided distal biceps peritendinous and intratendinous injections are feasible.
• These techniques show potential for managing distal biceps tendinopathy/bursopathy.
• Further clinical studies are warranted to confirm efficacy.