This is the second in a series of papers related to procedure-oriented joint anatomy. This article will review the anatomy of the elbow and its relationship to procedures in the clinical setting. Needle procedures of the elbow joint include medial and lateral epicondyle injections, olecranon bursa injection, elbow joint aspiration, phlebotomies in the antecubital fossa, and intramuscular injections such as trigger point and botulinum toxin injections. Complications related to these procedures include infection, skin atrophy, injuries to peripheral nerves, tendon rupture associated with the use of corticosteroids, iatrogenic vascular injuries, and chronic local pain. This article provides anatomically accurate schematics of the elbow anatomy relevant to needle procedures. Cross-sectional anatomical schematics of the elbow were drawn as they appear on axial and coronal projections. Superficial and deep landmarks are highlighted as well as sources of potential complications. These schematics allow for safer and more accurate needle procedures in the elbow area, for both nonguided and musculoskeletal ultrasound-guided techniques.
From the *Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Center for Trauma Rehabilitation Research, Quentin Mease Hospital, Harris County Hospital District, Houston, TX; †Department of Neurobiology and Anatomy, University of Texas School of Medicine, Houston, TX; and ‡Veterans Affairs Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center, Durham, NC and Research and Education Service Line, W G Hefner Veterans Affairs Medical Center, Salisbury, NC.
Received for publication August 17, 2011; accepted September 30, 2011.
Reprints: Oscar Sanchez, MD, Department of Physical Medicine and Rehabilitation, Quentin Mease Hospital, Suite No. 240, 3601 N MacGregor Way, Houston, TX 77004 (e-mail: firstname.lastname@example.org).