Lateral epicondyle injection is a useful diagnostic and therapeutic procedure for lateral epicondylitis of the elbow (tennis elbow). The condition is usually secondary to occupational or sports-related trauma or recurrent trauma.
After informed consent is obtained, the patient is placed in the sitting position, with the arm resting on the examination table, palm down, and the elbow flexed to 45 degrees. The elbow is palpated at the junction of the forearm extensor group at its attachment to the bone near the lateral epicondyle to determine the point of maximal tenderness. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. A 1½-in. (4-cm), 23-gauge needle is inserted at the point of maximal tenderness. After negative aspiration, a 5-mL mixture of 10 mg of triamcinolone acetonide acetate (or equivalent) and anesthetic agent is injected at the point of maximal tenderness (Fig. 67-39).
FIGURE 67-39. Lateral epicondyle injection. Approach for lateral epicondyle aspiration and injection.
The point of maximal tenderness is usually just medial and distal to the lateral epicondyle over the common tendon of the forearm extensor group at its attachment to the bone.
Serious complications are uncommon with injection of the lateral epicondyle of the elbow.