Orthopedics Book

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Acromioclavicular Joint Injection

Aka: Acromioclavicular Joint Injection, AC Joint Injection
  1. See also
    1. Shoulder Injection
    2. Glenohumeral Joint Injection
    3. Subacromial Space Injection
    4. Long Head of Biceps Injection
    5. Scapulothoracic Injection
    6. Joint Injection
    7. Injectable Corticosteroid
  2. Indications
    1. Osteolysis of distal clavicle
    2. Osteoarthritis
  3. 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
  4. Patient positioning
    1. Patient sits with arm resting at side
    2. Shoulder externally rotated
  5. 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
  6. References
    1. Pfenninger (1994) Procedures, p. 1036-54
    2. Larson (1996) Am Fam Physician 53(5):1637-43 [PubMed]
    3. Tallia (2003) Am Fam Physician 67(6):1271-8 [PubMed]

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