II. Preparation
- Syringe 3 ml
- Needle 25 to 27 gauge (1.25 to 1.5 inch)
- Methylprednisolone 20 mg (0.5 ml of 40 mg/ml solution)
- Lidocaine 1% 0.5 ml
III. Technique
- Patient positioned seated with wrist pronated and palm resting on a table
- Identify region of intersection
- Dorsal, radial wrist, typically 5 cm proximal to the wrist joint
- Region of overlap between dorsal compartment 1 and 2
- Palpable tenderness or swelling
- Injection Target is within bursa of Compartment 2 tendons
- Extensor Carpi Radialis Longus (ECRL)
- Extensor Carpi Radialis Brevis (ECRB)
-
Ultrasound Guidance with high frequency linear probe
- Place probe transverse (short axis, horizontal) to tendons at intersection of compartment 1 and 2
- Prepare the skin with antiseptic (e.g. Chlorhexidine, Povidone-Iodine)
- Inject the region of tendon cross-over and bursa
- Avoid injecting into the tendon