Editorial Commentary: First They Came for My Examination Skills: Diagnostic Injections of the Biceps Sheath Are No Substitute for a Careful Collaboration of History, Examination, and Clinical Acumen.

Abstract

Diagnostic injections have been used in the workup of many musculoskeletal complaints, especially when a good history and physical examination don't point to a concrete diagnosis. However, the accuracy of blind injections, especially in locations like the biceps sheath, has been called into question. This has led to the use of image guidance to improve injection accuracy, usually with great success. However, even with great accuracy, the diagnostic utility of an injection may still be quite limited because of fluid extravasation.