II. Preparation
- Needle: 25-27 gauge 1.5 inch
- Intraarticular Corticosteroid
- Methylprednisolone: 1 ml of 40 mg/ml or
- Betamethasone (Celestone Soluspan): 1 ml
- Lidocaine 1%: 5-7 ml
III. Indications
IV. Technique: Patient positioning
- Patient sits with arm resting at side
- Shoulder externally rotated
V. Technique: Posterior Approach
- Images
- Landmarks
- Find sulcus between head of Humerus and acromion
- Posterolateral corner of acromion (2-3 cm inferior)
- Injected with sterile technique
- Direct needle anteriorly toward coracoid process
- Insert needle to full length
- Fluid should flow easily
VI. Technique: Anterior Approach
- Landmarks
- Medial to head of Humerus
- Lateral to coracoid process by 1 cm
- Injected with sterile technique
- Direct needle posteriorly
- Angle slightly superior and lateral
- Pull-back and redirect needle if hits bone
VII. References
- Pfenninger (1994) Procedures, p. 1036-54
- Larson (1996) Am Fam Physician 53(5):1637-43 [PubMed]
- Tallia (2003) Am Fam Physician 67(6):1271-8 [PubMed]