Ultrasound-guided injection of the elbow: Cadaveric description for the proximal to distal approach.

Abstract

Ultrasound (US) guided intra-articular elbow injections are commonly performed in clinical practice. To describe a proximal to distal approach for US-guided intra-articular elbow injection. Cadaveric study. Academic institution. Both elbows of a single cadaver were injected with green-colored water-diluted latex dye using the US-guided proximal to distal approach. In the left elbow, the needle was kept in situ; in the right elbow, the needle was removed. Subsequently, a layer-by-layer anatomical dissection was performed in both elbows. Presence and distribution of the latex dye and location of the needle tip within the elbow joint capsule. Anatomical dissection of both elbows confirmed the correct intra-articular position of the needle tip in the left elbow as well as correct placement of the latex dye bilaterally. During layer-by-layer dissection of the left elbow, the position of the radial nerve was observed anterior to the needle. This cadaveric observation demonstrated that the US-guided proximal to distal approach is a convenient technique to access the elbow joint. Compared to the previously described techniques, the in-plane, proximal to distal approach may provide excellent needle visibility during the entire procedure, precisely targeting the articular space. The preliminary data need to be validated in additional clinical studies.