Ultrasound-Guided Injection of the Elbow: Cadaveric Description for the Proximal to Distal Approach.

OBJECTIVES: To describe a proximal to distal approach for ultrasound (US) guided intra-articular elbow injection.

DESIGN: Cadaveric study.

SETTINGS: Academic institution.

SUBJECTS: Single cadaveric specimen.

METHODS: Both elbows of a single cadaver were injected with green-colored water-diluted latex dye using the US-guided proximal to distal approach. In the left elbow, the needle was kept in situ; in the right elbow, the needle was removed. Subsequently, a layer-by-layer anatomical dissection was performed in both elbows.

MAIN OUTCOMES: Presence and distribution of the latex dye and location of the needle tip within the elbow joint capsule.

RESULTS: Anatomical dissection of both elbows confirmed the correct intra-articular position of the needle tip in the left elbow as well as correct placement of the latex dye bilaterally. During layer-by-layer dissection of the left elbow, the position of the radial nerve was observed anterior to the needle.

CONCLUSIONS: This cadaveric observation demonstrated that the US-guided proximal to distal approach is a convenient technique to access the elbow joint. Indeed, compared to the previously described techniques, the in-plane, proximal to distal approach may provide excellent needle visibility during the entire procedure, precisely targeting the articular space. Our preliminary data needs to be validated in additional clinical studies.