Ultrasound-Guided Bicep Tendon Injection

With the guidance of ultrasound imaging (a painless exam which uses high-frequency sound waves to produce instant images of the inside of your body), your doctor will inject your bicep with a steroid to alleviate your shoulder pain.

When you arrive for your procedure, the nurse will greet you and let the team know that you have arrived. You will be taken into the exam room and asked to change into a gown. You will be asked to sit on the exam table.

The technician and your doctor will then begin the ultrasound portion of the exam. The equipment for the ultrasound resembles a computer with a large screen. The technician will put the transducer – a small, hand-held device that is used to send and receive the ultrasound signals – on your shoulder and upper arm. This will allow your doctor to see inside your shoulder and help find the cause of the swelling. It will also help your doctor give an injection in the best possible place. The ultrasound exam is completely painless.

Once your doctor has determined the best place to put the injection, your doctor will clean the area and give you an anesthetic to numb the area. You will feel a small pinch as the anesthesia is injected. When the area is numbed, your physician will insert a small needle into your bicep and inject the steroid. Most patients do not report any pain during the procedure but you may feel slight pressure when the needle is inserted.

Once the procedure is complete, your doctor may put a small bandage on the site. You may be instructed to limit strenuous activity for a period of time (usually 24-hours) after the procedure. You will likely be able to return to normal activities after that.

You may feel slight discomfort or bruising after the procedure. In most cases this can be treated with over-the-counter pain medication. Please talk to your physician about any discomfort you may be experiencing after the procedure.

Your doctor will talk to you briefly after the procedure about any possible follow-up appointments you may need.

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone drop you off and pick you up. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Some other things to keep in mind in planning for this procedure include:

• Wear loose, comfortable clothing to the procedure.
• Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.
• The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a nurse from your doctor’s office will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
• When you arrive, make sure the nurse and radiologist know about any allergies you may have, especially allergies to local anesthetics, such as lidocaine. If there’s any chance you may be pregnant, tell your physician

On the day of your procedure you should:

• Wear comfortable, loose-fitting clothes
• Avoid bringing jewelry or valuables

The benefits of an ultrasound-guided bicep injection could include:

• Relief of shoulder pain and immobility
• Most patients do not report any pain or discomfort during the procedure
• Recovery time is short and patients can resume their normal activities

Risks you should be aware of include:

• As with any procedure, there is a slight risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
• In some cases patients report slight discomfort and swelling following the procedure. This can usually be controlled with over-the-counter pain medications. Talk your doctor if you experience any discomfort following the procedure.

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.