PERIARTICULAR TREATMENT: GENERAL TECHNIQUE

Tendinopathies can be treated with peritendinous

and intra-tendinous ARTHRYS injections under
ultrasound guidance.

ARTHRYS can be distributed part under the tendon

sheath close to the lesion/inflammation area, part
outside the sheath in the area surrounding the
injury/inflammation.

Use a needle of 26-28 G with a length of about 40

mm inserted at 90°.
 SHOULDER AND ROTATOR CUFF 1/2
1) Posterolateral approach: subacromial
injection in the small space between bony
acromion that sits on top of the shoulder and
the humeral head. A long 18 gauge needle
should 2-3cm anterior to the posterolateral
corner of the acromion. 1
3 2
2) Posterior approach: glenohumeral joint
injection. The needle is inserted 2-3 cm inferior
and medial to the posterolateral corner of the
acromion and directed anteriorly towards the
coracoid process

3) Anterosuperior approach: acromioclavicular

joint injection. The distal aspect of the clavicle
is palpated to identify the convexity of the AC
joint where the clavicle meets the acromion,
then the needle is inserted from an anterior
and superior angle and directed inferiorly.
Intra-articular injections of ARTHRYS 2.
Use a 23-28 G needle
with a length of about 50 mm
 SHOULDER AND ROTATOR CUFF 2/2

1) With a lateral or posterolateral approach,

insert the needle in the subacromial space

2) Insert the needle in the center of the

segment that ideally goes from the 1 4
acromioclavicular joint to the top of the 3
anterior axillary fold. 2
3) Insert the needle into the dimple of the
posterior aspect of the shoulder joint along the
vertical line passing from the posterior axillary
fold.

4) Insert the needle into the posterolateral Peri-articular injections of ARTHRYS 5.

dimple that forms between the acromion and Use a 26-28 G needle
the greater humeral tubercle. with a length of about 40 mm
EPICONDYLITIS TREATMENT

1) With the elbow flexed at 90°,

insert the needle towards the
epicondyle

2) Insert the needle at the tip of 2

the flexed elbow at 90° 3
1
3) With the elbow flexed at 90°,
insert the needle about 3-4 cm
distal to point 2

Intra-tendinous/intra-muscular injections of ARTHRYS 5.

Use a 26-28 G needle with a length of about 16 mm.
Enter at 90° at a depth of 5-6 mm.
EPITROCLEITIS TREATMENT

1) Insert the needle between the

trochlea and the olecranon on the 1
medial site of the elbow flexed at 90°
2
2) Insert the needle in the meddle of
the elbow crease inside the distal
biceps tendon.

Intra-tendinous/intra-muscular injections of ARTHRYS 5.

Use a 26-28 G needle with a length of about 16 mm.
Enter at 90° at a depth of 5-6 mm.
 YARROW (ACHILLES) TENDINOPATHY

1) Under ultrasound guidance insert the needle under the peritenon in

proximity of the inflammation/lesion area. Release part of the solution
just outside the tendon.

Intra-tendinous injections of ARTHRYS 5.

Use a 26-28 G needle with a length of about 40 mm.
Enter along the tendon direction at 30° - 45° at a depth of 5-6 mm.
 PERONAL TENDONITIS

1) Under ultrasound guidance insert the needle in the longitudinal

plane of the transducer from an anterior and inferior to posterior and
superior direction under the peritenon into the space between the two
tendons.

Intra-tendinous injections of ARTHRYS 5.

Use a 26-28 G needle with a length of about 40 mm.
Enter along the tendon direction at 30° at a depth of 5-6 mm.
 PLANTARIS FASCITIS

1) Insert the needle in line with the posterior edge of the medial
malleolus one fingerbreadth above the sole. Avoid to inject through
the base of the foot, because this approach can result in fat pad
atrophy.

Intra-tendinous injections of ARTHRYS 5.

Use a 26-28 G needle with a length of about 40 mm.
Enter at 90° at a depth of 20-25 mm.
PATELLAR TENDINOPATHY: THE JUMPER’S KNEE

1-2-3) With the knee relaxed and

slightly flexed, under ultrasound 1
guidance, insert the needle
under the peritenon near the 2
inflamed area. Release part of
the product also outside the
3
tendon.

Intra-tendinous / subcutaneous injections of ARTHRYS 5.

Use a 26-28 G needle with a length of about 30-40 mm.
Enter at 45°.