Syringe

Elbow Injections

Tennis Elbow Injection

My Usual Injection

  • 3mL or 5mL syringe

  • 25g 1/2 inch needle

  • 2mL 1% lidocaine

  • 1mL/6mg betamethasone (Celestone)

Procedure

  1. Obtain and document, at least, verbal consent for procedure

  2. Have the patient seated with the elbow flexed and resting on a pillow on his/her lap or on a hand table to the side

  3. Palpate the lateral epicondyle, and determine the most tender point

  4. Mark with a surgical skin marker

  5. Apply gloves

  6. Apply topical antibacterial x 3

  7. Apply analgesic, if desired (I use ethyl chloride)

  8. Slowly and controlled, insert needle (25 gauge), through the marked entry point, and advance to the bone

  9. Pull needle tip back just slightly

  10. Inject slowly

  11. Withdraw needle

  12. Wipe clean

  13. Apply bandage

Golfer's Elbow Injection

My Usual Injection

  • 3mL or 5mL syringe

  • 25g 1/2 inch needle

  • 2mL 1% lidocaine

  • 1mL/6mg betamethasone (Celestone)

Procedure

  1. Obtain and document, at least, verbal consent for procedure

  2. Have the patient supine with the shoulder abducted to 90° and externally rotated, and the elbow flexed to 90° resting on the exam table

  3. Palpate the medial epicondyle, and determine the most tender point.  Take care not to be too posterior, as to not inject the ulnar nerve.

  4. Mark with a surgical skin marker

  5. Apply gloves

  6. Apply topical antibacterial x 3

  7. Apply analgesic, if desired (I use ethyl chloride)

  8. Slowly and controlled, insert needle (25 gauge), through the marked entry point, and advance to the bone

  9. Pull needle tip back just slightly

  10. Inject slowly

  11. Withdraw needle

  12. Wipe clean

  13. Apply bandage

Intra-Articular Elbow Injection

My Usual Injection

  • 3mL or 5mL syringe

  • 25g 1/2 inch needle

  • 2mL 1% lidocaine

  • 1mL/40mg triamcinolone (Kenolog)

Procedure

  1. Obtain and document, at least, verbal consent for procedure

  2. Have the patient seated with the elbow flexed and resting on a pillow on his/her lap or on a hand table to the side

  3. Palpate the lateral epicondyle, radial head, and olecranon process.  Near the center of the triangle formed by these landmarks is the lateral joint space.  Palpate and mark with a surgical skin marker, as this is the injection site.

  4. Apply gloves

  5. Apply topical antibacterial x 3 

  6. Apply analgesic, if desired (I use ethyl chloride)

  7. Slowly and controlled, insert needle (25 gauge), through the marked entry point

  8. Inject slowly

  9. Withdraw needle

10. Wipe clean

11. Apply bandage