Elbow Ultrasound Guided Injections

Elbow Diagnostic Ultrasound Scan

The Anatomy of a Elbow Ultrasound Scan

An ultrasound scan is an invaluable tool when diagnosing elbow pain conditions. The majority of musculoskeletal conditions of the elbow, are not caused by the joint itself but caused by conditions affecting the tendons and bursae which surround the elbow for which elbow ultrasound is the gold standard. In the smaller percentage of articular elbow pain conditions, elbow ultrasound can also reliably diagnose inflammation and elbow joint effusions.

Ultrasound diagnosis of tennis elbow and golfers elbow is conducted by placing the ultrasound transducer on the lateral epicondyle (the bony insertion of the common extensor tendon in tennis elbow) or the medial epicondyle on the inside of the elbow (the bony insertion of the common flexor tendon in golfers elbow). The clinician is able to image irregularities at the insertion point of the tendons, diagnose loss of normal fibrillar pattern or measure any tendon tears.

The distal biceps tendon may also give rise to pain at its insertion on to the radius bone in the forearm. Although technically challenging, this tendon can be imaged to it's attachment to exclude any tendon tear or inflammation to the underlying fluid-filled bursa (bicipitoradial bursa).

Similarly, the triceps tendon at the back of the elbow can be imaged inserting to the olecranon bone. Elbow ultrasound can be used to locate bony insertional defects or calcifications to the triceps tendon. The posterior (rear) of the elbow is also the location of olecranon bursitis which can be readily diagnosed and measured using diagnostic ultrasound.

Less common forms of elbow musculoskeletal pain, include nerve entrapments or "neuropathies". "Cubital tunnel syndrome" affects the ulnar nerve as it passes through the elbow in the cubital tunnel. "Supinator syndrome" affects the radial nerve as it passes through the supinator muscle and through a region known as the "Arcade of Frohse". 

Ultrasound imaging can exclude any swelling or thickening to these nerves as well as locate any bony or soft tissue structures causing compression to these nerves within their anatomical canals.

The distal biceps tendon may also give rise to pain at its insertion on to the radius bone in the forearm. Although technically challenging, this tendon can be imaged to it's attachment to exclude any tendon tear or inflammation to the underlying fluid-filled bursa (bicipitoradial bursa).

Similarly, the triceps tendon at the back of the elbow can be imaged inserting to the olecranon bone. Elbow ultrasound can be used to locate bony insertional defects or calcifications to the triceps tendon. The posterior (rear) of the elbow is also the location of olecranon bursitis which can be readily diagnosed and measured using diagnostic ultrasound.

Less common forms of elbow musculoskeletal pain, include nerve entrapments or "neuropathies". "Cubital tunnel syndrome" affects the ulnar nerve as it passes through the elbow in the cubital tunnel. "Supinator syndrome" affects the radial nerve as it passes through the supinator muscle and through a region known as the "Arcade of Frohse". 

Ultrasound imaging can exclude any swelling or thickening to these nerves as well as locate any bony or soft tissue structures causing compression to these nerves within their anatomical canals.