In short, we strongly advocate the use of US imaging not only in the diagnostic phase but also/especially in the interventional treatment of trigger finger for two main reasons. The first is the possibility of clearly identifying the neurovascular bundle located in the palmar side of the hand (interindividual variability) in order to perform a safe injection.
The second is the possibility of planning a painless needle route (in our case, a longitudinal oblique plane) not simply based on anatomical landmarks (metacarpal head by palpation) but on visualizing in real time the needle's progression through the tissue planes until the synovial sheath of the flexor tendons under the A1 pulley, avoiding the neurovascular structures.