Orthopedics Book

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Glenohumeral Joint Injection

Aka: Glenohumeral Joint Injection, Rotator Cuff Injection
  1. See also
    1. Shoulder Injection
    2. Acromioclavicular Joint Injection
    3. Subacromial Space Injection
    4. Long Head of Biceps Injection
    5. Joint Injection
    6. Injectable Corticosteroid
  2. 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
  3. Indications
    1. Shoulder Osteoarthritis
    2. Adhesive Capsulitis
    3. Rheumatoid Arthritis affecting the Shoulder
  4. Technique: Patient positioning
    1. Patient sits with arm resting at side
    2. Shoulder externally rotated
  5. 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
  6. 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
  7. 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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