MSK Ultrasound Procedures


Radiocapitellar Joint Injection



Equipment and Medications

  • probe: 14Mhz Linear probe
  • 25g 1.5” needle
  • 3cc syringe with 1cc 0.5% ropivacaine and 1cc injectable steroid (kenalog 40mg/cc)
  • 5cc syringe with 5cc of 1% Lidocaine
  • Procedure tray
  • Equipment

    Medications



    Procedure Instructions:


    Instructions
    1. Standard pre procedure workup (consent, indications, contraindications, allergies). Assess pain level.
    2. Position patient sitting with arm slightly flexed and thumb up. position
    Picture of probe overlying the radiocapitellar joint.
    3. Place probe perpendicular to the joint and mark probe location and probable injection site
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    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.
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    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.
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  • Sagittal T1 Fat Saturated image demonstrating an elbow arthrogram, which was obtained after administration of contrast via ultrasound.
    9. Assess pain level.

     


    References

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