Elbow
Ultrasound-guided injection for epicondylitis
The inflamed tendon in epicondylitis is treated with precision under direct ultrasound visualisation: the needle reaches the painful area of the tendon for a targeted treatment (corticosteroid injection or, in cases with fluid, lavage of the microtears).
How it is performed
Epicondylitis is inflammation of the tendons that anchor the forearm muscles to the epicondyle (lateral, in tennis elbow, or medial, in golfer's elbow). Using ultrasound, the thickened and hypervascular tendon segment is identified, sometimes with microtears; under direct visualisation a thin needle reaches the site and a corticosteroid injection is performed, or, when fluid is present, a mechanical lavage of the microtears. Ultrasound guidance allows nerve structures to be avoided and the medication to be deposited exactly where needed. This is an ultrasound-guided procedure performed under local anaesthesia, through an access point of a few millimetres.
Who it is for
- Lateral or medial epicondylitis with persistent pain on gripping and lifting
- Lack of response to rest, brace, physiotherapy and medications
- Tendinopathy documented on ultrasound with signs of inflammatory activity
Recovery
You return home immediately. In the first 48 hours it is advisable to rest from the painful sporting or work activity and apply ice; benefit develops over the following days and physiotherapy is started once pain has decreased.
Conditions treated in this area: lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), wrist extensor/flexor tendinopathy.
Scientific evidence
Reviews and randomised studies show that ultrasound-guided injection offers faster and more lasting pain relief than a freehand injection in lateral epicondylitis, thanks to greater placement accuracy. Treatment of tendon microtears and combined use with structured physiotherapy programmes improve long-term outcomes.
References on PubMed
- Accuracy of ultrasound-guided versus blind corticosteroid injections in lateral epicondylitis: a systematic review and meta-analysis
Kong KA, Lee HJ, et al. — Skeletal Radiol, 2020 · PMID 31802253
- Ultrasound-guided steroid injection combined with dry needling vs dry needling alone in lateral epicondylitis: a randomized controlled trial
Kumari R, Bala S, et al. — J Ultrasound, 2021 · PMID 34036241
- Autologous blood injection versus corticosteroid injection for lateral epicondylitis: a randomized controlled trial
Lin CL, Huang TF, et al. — J Shoulder Elbow Surg, 2018 · PMID 29224814
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.