Bicipital groove steroid injection

Anserine bursitis is most common in obese, middle-aged to elderly women with knee osteoarthritis. Other predisposing factors include genu valgum, hamstring contractures, and an out-toeing gait. Patients complain of medial knee pain that can sometimes radiate to the posterior medial thigh. It is accentuated with stair climbing. On examination, pain and tenderness are localized to approximately 3 to 5 inches below the medial knee joint line. Treatment consists of NSAIDs, stretching exercises of the adductor and quadriceps muscles, and corticosteroid injection into the bursa. 9

Biceps Tendon Sheath Injection - Lateral View

  • Mark the injection site with the pen tip in order to leave an impression in the skin — Point of maximal tenderness in bicipital groove.
  • Clean the skin thoroughly with as many alcohol swabs as needed (usually only one is needed).
  • Patient position: Lying supine with arm supinated
  • With the 25G needle/syringe, enter the skin going cephalad at a 20-30-degree angle .  If you enter tough, gritty tissue (biceps tendon), pull back a mm or two and redirect at a more shallow angle to get under the tendon sheath (of the long head of the biceps).
  • Aspirate to make sure you’re not in any vessel.
  • After negative aspiration, inject the full contents of the syringe.  Redirect or withdraw the needle slightly if it isn’t flowing easily (DO NOT INJECT UNDER PRESSURE — YOU’RE LIKELY IN THE ACTUAL BICEPS TENDON)
  • Withdraw the needle and apply band-aid.
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    Bicipital groove steroid injection

    bicipital groove steroid injection

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