Orthopedics Book

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Biceps Tendon InjectionAka: Long Head of Biceps Injection, Injection of Long Head of Biceps

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  1. See also
    1. Shoulder Injection
    2. Glenohumeral Joint Injection
    3. Acromioclavicular Joint Injection
    4. Subacromial Space Injection
    5. Scapulothoracic Injection
    6. Joint Injection
    7. Injectable Corticosteroid
  2. Indications
    1. Bicipital Tendonitis
  3. Preparation
    1. Needle: 25-27 gauge, 1 to 1.5 inch
    2. Intraarticular Corticosteroid
      1. Methylprednisolone: 0.25 ml of 40 mg/ml or
      2. Betamethasone (Celestone Soluspan): 0.25 ml
    3. Lidocaine 1%: 0.5 ml
  4. Patient positioning
    1. Patient sits with arm resting at side
  5. Approach
    1. Images
      1. OrthoShoulderInjectBiceps.jpg
    2. Landmarks
      1. Identify bicipital tendon in bicipital groove
      2. Mark point of maximal tenderness over groove
    3. Injected with sterile technique
      1. Direct needle parallel to bicipital groove
      2. Needle enters skin at 30 degrees
      3. Do not inject bicipital tendon
      4. Infiltrate area around groove, but not into tendon
        1. Flow resisted when needle is inside tendon
        2. Withdraw needle slightly and retry
        3. Continue to withdraw until not in tendon
  6. Complications
    1. Bicipital tendon rupture
      1. Associated with intratendinous injection
      2. Do not inject bicipital tendon
  7. References
    1. Pfenninger (1994) Procedures, p. 1036-54
    2. Larson (1996) Am Fam Physician 53(5):1637
    3. Tallia (2003) Am Fam Physician 67(6):1271

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