II. Indications

  1. Osteolysis of distal clavicle
  2. Osteoarthritis

III. Preparation

  1. Needle: 25-27 gauge, 1 to 1.5 inch
  2. Intraarticular Corticosteroid
    1. Methylprednisolone: 0.25 - 0.50 ml of 40 mg/ml or
    2. Betamethasone (Celestone Soluspan): 0.25 to 0.50 ml
  3. Lidocaine 1%: 0.5 ml

IV. Patient positioning

  1. Patient sits with arm resting at side
  2. Shoulder externally rotated

V. Approach

  1. Images
    1. OrthoShoulderInjectAC.jpg
  2. Landmarks: Identify AC joint
    1. Palpate clavicle to distal aspect
    2. Slight depression where clavicle meets acromion
  3. Injected with sterile technique
    1. Insert needle from anterior and superior approach
    2. Direct needle inferiorly

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