See also
Indications
1. Subacromial bursitis (Subdeltoid Bursitis)
2. Rotator Cuff Impingement or tendinosis
3. Adhesive Capsulitis
Efficacy
1. Study of n=40, DBRT, with mean age of 57 years
2. After 30 weeks: Assessment moderate to severe pain
  1. Subacromial Corticosteroid Injection: 16% had pain
  2. Subacromial Lidocaine injection: 71% had pain
3. Reference
  1. Blair (1996) J Bone Joint Surg 78A: 1685-9
Preparation
1. Needle: 25-27 gauge 1.5 inch
2. Intraarticular Corticosteroid
  1. Methylprednisolone: 1 ml of 40 mg/ml or
  2. Betamethasone (Celestone Soluspan): 1 ml
3. Lidocaine 1%: 5-7 ml
Approach (Lateral Shoulder)
1. Images
2. Landmarks
  1. Posterior and lateral aspect of Shoulder
  2. Inferior to lower edge of posterolateral acromion
3. Injected with sterile technique
  1. Insert inferior to acromion at lateral Shoulder
  2. Direct needle toward opposite nipple
  3. Insert needle to full length
  4. Fluid should flow easily
References
1. Pfenninger (1994) Procedures, p. 1036-54
2. Larson (1996) Am Fam Physician 53(5):1637-43
3. Tallia (2003) Am Fam Physician 67(6):1271-8

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 2/5/2012 and last published on 5/14/2013.

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