Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;24(2):93-97.
doi: 10.5397/cise.2021.00010. Epub 2021 May 27.

Distal biceps tendon injection

Jacqueline van der Vis  1 , Stein J Janssen  2 , Ronald L A W Bleys  3 , Denise Eygendaal  2   4 , Michel P J van den Bekerom  1   5 ; Elbow Study Collaborative
Affiliations

Distal biceps tendon injection

Jacqueline van der Vis et al. Clin Shoulder Elb. 2021 Jun.

Abstract

Background: Injection therapy around the distal biceps tendon insertion is challenging. This therapy may be indicated in patients with a partial distal biceps tendon tear, bicipitoradial bursitis and tendinopathy. The primary goal of this study was to determine the accuracy of manually performed injections without ultrasound guidance around the biceps tendon.

Methods: Seven upper limb specialists, two general orthopedic specialists, and three orthopedic surgical residents manually injected a cadaver elbow with acrylic dye using an anterior and a lateral infiltration approach. After infiltration the cadaveric elbows were dissected to determine the location of the acrylic dye.

Results: In total, 79% of the injections were localized near the biceps tendon. Of these injections, 20% were localized on the radius near the bicipitoradial bursa. In total, 53% of the performed infiltrations were injected by anterior and 47% by lateral approaches. Of the injections near the distal biceps (79%), 47% were injected by an anterior and 53% by a lateral approach. Of the injections on the radius (20%), 33% were injected by anterior and 67% by lateral approach. Of the inaccurate injections (21%), 75% were injected anterior and 25% lateral.

Conclusion: Manual infiltration without ultrasound guidance for distal biceps pathology lacks accuracy. We therefore recommend ultrasound guidance for more accurate infiltration.

Keywords: Biceps tendinopathy; Bicipitoradial bursitis; Elbow; Injection therapy; Partial biceps tendon tear.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

None.

References

    1. Sellon JL, Wempe MK, Smith J. Sonographically guided distal biceps tendon injections: techniques and validation. J Ultrasound Med. 2014;33:1461–74. - PubMed
    1. Sanli I, Morgan B, van Tilborg F, Funk L, Gosens T. Single injection of platelet-rich plasma (PRP) for the treatment of refractory distal biceps tendonitis: long-term results of a prospective multicenter cohort study. Knee Surg Sports Traumatol Arthrosc. 2016;24:2308–12. - PubMed
    1. Barker SL, Bell SN, Connell D, Coghlan JA. Ultrasound-guided platelet-rich plasma injection for distal biceps tendinopathy. Shoulder Elbow. 2015;7:110–4. - PMC - PubMed
    1. Mautner K, Stafford CD, 2nd, Nguyen P. Ultrasound-guided distal bicep tendon injection using a posterior approach. PM R. 2015;7:1007–10. - PubMed
    1. Bain GI, Johnson LJ, Turner PC. Treatment of partial distal biceps tendon tears. Sports Med Arthrosc Rev. 2008;16:154–61. - PubMed

LinkOut - more resources