II. 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

IV. Technique: Patient positioning

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

V. Technique: Posterior Approach

  1. Images
    1. OrthoShoulderInjectPosterior.jpg
  2. Landmarks
    1. Find sulcus between head of Humerus and acromion
    2. Posterolateral corner of acromion (2-3 cm inferior)
  3. Injected with sterile technique
    1. Direct needle anteriorly toward coracoid process
    2. Insert needle to full length
    3. Fluid should flow easily

VI. Technique: Anterior Approach

  1. Landmarks
    1. Medial to head of Humerus
    2. Lateral to coracoid process by 1 cm
  2. Injected with sterile technique
    1. Direct needle posteriorly
    2. Angle slightly superior and lateral
    3. Pull-back and redirect needle if hits bone

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