Injection into the bicipital groove may be indicated in biceps tendonitis, though in many cases the symptoms are caused by subacromial impingement. An injection of the bicipital groove might however be of diagnostic use, particularly if subacromial injection has failed.
It should be noted that the patient may be at increased risk of tendon rupture as a direct effect of the steroid on the tendon after the injection has been performed.
Approaching the seated patient from the front, with the patient's elbow flexed and the shoulder slightly extended and externally rotated, the biceps tendon and the bicipital groove can be palpated. A needle is then either introduced superiorly and tangentially to the tendon or deeper into the groove with contact to bone. The injection is then delivered ensuring that there is no resistance to flow.
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