US-Guided Injections

Subacromial–Subdeltoid Bursa Injection

Shoulder impingement syndromes · Rotator cuff–related pain with bursitis · Primary or secondary subacromial–subdeltoid bursitis

Glenohumeral Joint Injection (Posterior Approach)

Adhesive capsulitis · Glenohumeral osteoarthritis/synovitis · Diagnostic intra-articular anesthesia

Glenohumeral Joint Injection (Anterior Rotator Interval)

Glenohumeral osteoarthritis or synovitis · Adhesive capsulitis · Diagnostic intra-articular anesthesia · Convenient anterior alternative when combining with biceps tendon sheath injection

Acromioclavicular (AC) Joint Injection

AC joint arthritis/sprain · Distal clavicle osteolysis · Isolated AC pain

Long Head of the Biceps Tendon Sheath Injection

Biceps tendon sheath inflammation · Diagnostic sheath injection

Radiocapitellar Joint Injection (Lateral Elbow)

Elbow arthritis · Lateral elbow joint pain · Synovitis/effusion · Diagnostic anesthetic

Common Extensor Tendon Origin Injection (Lateral Epicondyle)

Lateral epicondylitis with tendon surface pain or degeneration

Carpal Tunnel Injection

Median nerve compression (carpal tunnel syndrome)

First Dorsal Compartment Injection (De Quervain's)

De Quervain's tenosynovitis (APL/EPB)

First Carpometacarpal (CMC) Joint Injection (Thumb Base / Basal Joint)

Thumb basal joint (1st CMC) arthritis or synovitis

Trigger Finger (A1 Pulley) Injection

Trigger finger (stenosing tenosynovitis) · Tendon locking/catching

Anterior Intra-articular Injection (Femoral Head–Neck Junction)

Hip osteoarthritis · Labral irritation · Diagnostic anesthetic

Greater Trochanteric Pain Syndrome — Peritendinous Injection

Greater trochanteric pain syndrome (gluteus medius/minimus tendinopathy ± peritendinous fluid). True isolated bursitis is uncommon.

Piriformis Injection

Piriformis syndrome with sciatic irritation · Deep gluteal pain / non-spinal sciatica

Sacroiliac (SI) Joint Injection

Suspected SIJ-mediated pain (single intra-articular block is one of several diagnostic tools — fluoroscopic confirmation with contrast remains more rigorous than US for true intra-articular placement) · Therapeutic injection after failed conservative care

Proximal Hamstring (Ischial Tuberosity) Injection

Proximal hamstring tendinopathy · Ischiogluteal bursitis

Suprapatellar Recess Injection

Knee osteoarthritis · Synovitis/effusion · Diagnostic anesthetic

Iliotibial Band (IT Band) Peritendinous Injection

Iliotibial band syndrome (ITBS) — lateral knee pain from inflammation of innervated loose connective/fat tissue deep to the distal ITB at the lateral femoral epicondyle (impingement zone at 20–30° flexion) · Distal ITB tendinopathy or insertional enthesopathy at Gerdy tubercle (peritendinous approach) · Diagnostic anesthetic block to confirm LFE as pain generator vs lateral meniscus, popliteus, LCL, or biceps femoris pathology · Snapping IT band over the LFE with associated peritendinous fluid

Pes Anserine Bursa Injection (Medial Knee)

Pes anserine bursitis — inflammation of the anserine bursa deep to the conjoined sartorius, gracilis, and semitendinosus (SGT) tendons at the proximal medial tibia · Pes anserine tendinopathy or insertional enthesopathy of the conjoined SGT tendons · Medial knee pain superimposed on osteoarthritis — pes anserine pain is present in 20–75% of patients with medial compartment OA · Post-traumatic or post-surgical pes anserine pain, including after hamstring harvest for ACL reconstruction · Diagnostic blockade to confirm the pes anserine as the pain generator before escalating management

Tibiotalar (Ankle) Joint Injection

Ankle osteoarthritis · Synovitis · Diagnostic anesthetic

Peroneal Tendon Sheath Injection

Peroneal tenosynovitis (primary indication — inflammation of the shared tendon sheath) · Peroneal tendinopathy (peroneus longus/brevis)

Plantar Fascia (Perifascial) Injection

Plantar fasciitis (heel pain) requiring perifascial therapy · NOT for plantar fibromatosis, retrocalcaneal bursitis, or tarsal tunnel syndrome — re-diagnose if US shows a mass lesion or tunnel-level pathology

Morton's Neuroma Injection (Dorsal Approach)

Interdigital neuralgia (Morton's neuroma) · Intermetatarsal bursitis

Tarsal Tunnel (Posterior Tibial Nerve) Injection

Tarsal tunnel syndrome with burning pain, numbness, and paresthesia in the heel and plantar foot · Entrapment neuropathy of the posterior tibial nerve beneath the flexor retinaculum · Medial and lateral plantar nerve compression at the porta pedis · Post-traumatic tarsal tunnel syndrome from ankle fractures or space-occupying lesions · Idiopathic tarsal tunnel syndrome with positive Tinel sign at the medial malleolus · Diabetic peripheral neuropathy with tibial nerve entrapment component