Medial epicondyle injection is a useful diagnostic and therapeutic procedure for medial epicondylitis (golfer’s elbow or tortilla elbow).
After informed consent is obtained, the patient is placed in the sitting position, with the arm resting on the examination table, palm up, 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 at 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.
The point of maximal tenderness is usually just lateral and distal to the medial epicondyle over the common tendon of the forearm flexor group at its attachment to the bone.
Avoid injecting the ulnar nerve in the groove just behind the medial epicondyle.