I am (negatively) impressed by the result of (1) published last week: they quantified how often injections for tennis elbow are correctly localized. Only 3 out of 10 were!
Of the 10 performed injections, only 3 injections (30 %) were at least partially located at the ECRB (extensor carpi radialis brevis) tendon. Six (60 %) out of 10 injections were also located intra-articular. Six injections were located (totally or partially) at the ECRL (extensor carpi radialis longus) tendon. The acrylic dye was also located at the anconeus muscle (n = 3), lateral epicondyle (n = 3), triceps muscle (n = 2), brachioradialis muscle (n = 1). The number of perforations ranged from 1 to 10 and the amount of injected fluid ranged from 1 to 2 cc.
Are there any similar studies (ideally of larger scale) confirming that surprisingly low injection accuracy for tennis elbow? I am mostly interested in both medical and lateral epicondylitis (a.k.a. epicondylopathy, tennis/golfer elbow, enthesopathy, enthesopathy of the ECRB), but also curious about other tendinopathies.
- (1) Keijsers, R et al. Knee Surg Sports Traumatol Arthrosc (2016). Injection of tennis elbow: Hit and miss? A cadaveric study of injection accuracy doi:10.1007/s00167-016-4212-0 ; http://link.springer.com/article/10.1007%2Fs00167-016-4212-0 ; http://sci-hub.cc/10.1007/s00167-016-4212-0