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Subacromial Space InjectionAka: Subacromial Corticosteroid Injection

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  1. See also
    1. Shoulder Injection
    2. Glenohumeral Joint Injection
    3. Acromioclavicular Joint Injection
    4. Long Head of Biceps Injection
    5. Joint Injection
    6. Injectable Corticosteroid
  2. Indications
    1. Subacromial bursitis (Subdeltoid Bursitis)
    2. Rotator Cuff Impingement or tendinosis
    3. Adhesive Capsulitis
  3. 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
  4. 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
  5. Approach (Lateral shoulder)
    1. Images
      1. OrthoShoulderInjectLateral.jpg
    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
  6. References
    1. Pfenninger (1994) Procedures, p. 1036-54
    2. Larson (1996) Am Fam Physician 53(5):1637
    3. Tallia (2003) Am Fam Physician 67(6):1271

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