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Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia )

CPT4 code

Name of the Procedure:

Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar fascia)

Summary

This procedure involves injecting medication into a specific tendon sheath or ligament in the body to reduce inflammation and relieve pain. Commonly, it is used for conditions such as plantar fasciitis, where the fascia at the bottom of the foot is inflamed.

Purpose

The procedure is designed to relieve pain, reduce inflammation, and promote healing in cases of tendonitis or ligament injuries. The main goal is to improve mobility and reduce discomfort in the affected area.

Indications

  • Persistent pain and inflammation in a tendon, ligament, or aponeurosis
  • Conditions such as plantar fasciitis, tendonitis, or bursitis
  • Failure to respond to conservative treatments like physical therapy and medications
  • Diagnostic confirmation of a specific condition through imaging or physical examination

Preparation

  • Patients may be advised to avoid certain medications, such as blood thinners, before the procedure.
  • Diagnostic tests, such as MRI or ultrasound, may be performed to precisely identify the affected area.
  • Patients should inform their healthcare provider of any allergies or medical conditions.

Procedure Description

  1. The patient is positioned to allow easy access to the affected area.
  2. The skin over the injection site is cleaned with an antiseptic solution.
  3. Local anesthesia may be applied to numb the area.
  4. A needle is inserted into the specific tendon sheath, ligament, or aponeurosis.
  5. Medication, typically a corticosteroid mixed with a local anesthetic, is injected.
  6. The needle is withdrawn, and the injection site is covered with a small bandage.

Duration

The entire procedure typically takes about 15 to 30 minutes.

Setting

This procedure is usually performed in an outpatient clinic, hospital, or surgical center.

Personnel

  • A physician (often an orthopedic surgeon or a specialist in sports medicine)
  • A nurse or medical assistant

Risks and Complications

  • Common: Pain at the injection site, temporary increase in pain or inflammation
  • Rare: Infection, allergic reaction, tendon rupture, nerve damage

Benefits

  • Rapid relief from pain and inflammation
  • Improved mobility and function of the affected area
  • Avoidance or delay of surgical intervention

Recovery

  • Patients are usually advised to rest the affected area for a short period after the injection.
  • Ice packs and over-the-counter pain relievers can help manage post-procedure discomfort.
  • Recovery time varies but most patients resume normal activities within a few days.
  • Follow-up appointments may be scheduled to monitor progress and response to treatment.

Alternatives

  • Physical therapy
  • Oral or topical anti-inflammatory medications
  • Orthotic devices or supportive footwear
  • Surgical intervention in severe or unresponsive cases

Patient Experience

During the procedure, patients may feel a brief sting or pressure at the injection site. Afterward, there might be some soreness or swelling, which can be managed with ice and pain relievers. Most patients experience significant relief within days to weeks following the injection.

Medical Policies and Guidelines for Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia )

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