|1. Standard pre procedure workup (consent, indications, contraindications, allergies). Assess pain level.|
|2. Position patient sitting with arm slightly flexed and thumb up.||
Picture of probe overlying the radiocapitellar joint.
|3. Place probe perpendicular to the joint and mark probe location and probable injection site|
|4. Clean x 3 with betadine or chlorhexidine.|
|5. Sterile drape and sterile probe cover.|
|6. Inject 1% lidocaine superficially with 25g 1.5” needle. Advance needle to the radial head underneath the joint capsule. Then, unscrew syringe from needle for greater needle control.|
|7. Under ultrasound guidance, advance needle into the radiocapitellar joint space. Test inject with 1% lidocaine. If no resistance, switch 1% lidocaine for injectable steroid mixture. If there is resistance, reposition needle and test inject again. Inject 2 cc of injectable steroid/anesthetic mixture.||8. Pull needle out and follow standard post-procedure protocol with cleaning off the skin and placing a bandage.||
Post procedure images demonstrating distention of the joint in the posterior recess.
|9. Assess pain level.|