Ultrasound is a fast, reliable and radiation-free method for the assessment of a wide range of pathological conditions, as well as for the guidance of percutaneous interventional procedures around the elbow, hand and wrist. Intraarticular and periarticular interventional procedures can be easily performed under continuous ultrasound monitoring to ensure correct needle positioning and medication delivery to a specific target. The most common ultrasound-guided procedures performed around the elbow, wrist, and hand are described in this review, excluding carpal tunnel procedures. Specifically, elbow
steroid injections are performed in patients with inflammatory disorders, while
hyaluronic acid can be administered in case of
osteoarthritis. Septic olecranon
bursitis requires percutaneous drainage for diagnosis and appropriate treatment.
Dry needling and injection of regenerative medications, such as blood derivatives, are among the treatment options for lateral epicondylosis.
Steroid injections are performed to give symptom relief in patients with
ulnar neuropathy at the elbow. Hand and wrist
steroid injections are performed in case of
osteoarthritis, subsequently followed by
hyaluronic acid injections, and in inflammatory disorders. Wrist ganglia can be safely aspirated and injected with
steroids under ultrasound guidance. De Quervain's
tenosynovitis and trigger finger are chronic
tenosynovitides of the wrist and digits, respectively, which can be treated with
steroid injections, subsequently followed by
hyaluronic acid injections. In conclusion, proper knowledge of the musculoskeletal disorders around the elbow, hand and wrist, as well as US-guided treatment options and operator training, are prerequisites to achieve good outcomes.