The Elbow

Bicipito-Radial Bursitis

Treatment

Consists of one to two infiltrations with 20 mg triamcinolone.
Due to the presence of the neurovascular bundle the anterior
route is not safe and the infiltration must be performed via dorsal.
The position is the same as for infiltration of the tenoperiosteal
insertion of the biceps on the radial tuberosity.

Material: A thin needle, 3 cm long is fited to a 2 cc syrine, filled with
20 mg triamcinoloneacetondide

Position: The patient lies prone on the couch.
The upper arm is passively held in external rotation by his side.
The forearm is put in full pronation;
attention: the upper arm must remain in lateral rotation !!

Palpation
Palpate the head of the radius
Palpate the lateral border of the ulna
Radial tuberosity and biceps insertion can be felt just lateral of the posterior edge of the ulna end about three fingers distal of the head of the radius.

Technique: The needle is inserted just cranial to the biceps tendon and pushed downwards just laterally to the ulna until it hists the shaft of the radius.
The infiltration is performed without appreciable tissue resistance.

Follow up:

almost no after pain.
Relative rest during a week.
The patient is seen after two weeks and if the tests are not
completely negative, a second infiltration is given.
Most cases one or two infiltrations suffice.