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Subacromial Space Injection
Aka: Subacromial Space Injection, Subacromial Corticosteroid Injection
- See also
- Shoulder Injection
- Glenohumeral Joint Injection
- Acromioclavicular Joint Injection
- Long Head of Biceps Injection
- Joint Injection
- Injectable Corticosteroid
- Indications
- Subacromial Bursitis (Subdeltoid Bursitis)
- Rotator Cuff Impingement or Tendinosis
- Adhesive Capsulitis
- Efficacy
- After 30 weeks: Assessment moderate to severe pain
- Study of n=40, DBRT, with mean age of 57 years
- Subacromial Corticosteroid Injection: 16% had pain
- Subacromial Lidocaine injection: 71% had pain
- Blair (1996) J Bone Joint Surg 78A: 1685-9 [PubMed]
- Preparation
- Needle: 25-27 gauge 1.5 inch
- Intraarticular Corticosteroid
- Methylprednisolone: 1 ml of 40 mg/ml or
- Betamethasone (Celestone Soluspan): 1 ml or
- Triamcinolone Acetonide (Kenalog) 1 ml of 40 mg/ml
- Anesthetic
- Lidocaine 1%: 5 ml and/or
- Bupivacaine 0.25%: 4 ml
- Technique: Approach (Lateral Shoulder)
- Images

- Landmarks
- Posterior and lateral aspect of Shoulder
- Inferior to lower edge of posterolateral acromion
- Injected with sterile technique
- Insert inferior to acromion at lateral Shoulder
- Direct needle toward opposite nipple
- Insert needle to full length
- Fluid should flow easily
- Imaging: Ultrasound guidance
- Indications
- Obesity or otherwise obscured bony landmarks
- Otherwise landmarks are easily palpated and Ultrasound adds little to the procedure
- Technique
- High frequency, Linear-array probe (vascular, small parts, superficial)
- Vertically positioned over the lateral Shoulder with the superior aspect of the probe against the acromion
- Subacromial space access will be inferior to the acromion (identified by bone-related shadowing behind the acromion)
- References
- Dogu (2012) Am J Phys Med Rehabil 91(8): 658-65 [PubMed]
- 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]