II. Indications: Refractory to conservative measures
- Osteoarthritis
- Rheumatoid Arthritis
- Gout
-
Radial Head Fracture diagnosis
- Blood or fat globules on aspiration
III. Preparation
- Needle (with 5-10 cc syringe)
- Gauge: 18-22 to aspirate, 25 to inject
- Length: 1.5 inches
- Injection Solution
- Lidocaine 1%: 3-5 ml
- Corticosteroid options
- Methylprednisolone (40 mg/ml): 1-2 ml or
- Celestone Soluspan (3 mg/ml): 1-2 ml
IV. Technique
- Position patient
- Patient supine
- Elbow flexed at 45 degrees
- Hand resting in neutral position by thigh
- Mark landmarks of lateral triangle
- Lateral olecranon
- Lateral epicondyle
- Radial head
- Needle insertion
- Apply betadine or hibiclens to area
- Insert needle perpendicular to skin
- Needle inserted at center of lateral triangle
- Needle aimed toward medial epicondyle
- Redirect needle if bone reached
- Aspirate for blood prior to injection
V. References
- Pfenninger (1994) Procedures, Mosby, p. 1045
- Cardone (2002) Am Fam Physician 66(11):2097-100 [PubMed]
