Procedure

Glenohumeral Joint Injection

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Glenohumeral Joint Injection, Rotator Cuff Injection

  • 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
  • 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
  • Indications
  1. Shoulder Osteoarthritis
  2. Adhesive Capsulitis
  3. Rheumatoid Arthritis affecting the Shoulder
  • Technique
  • Patient positioning
  1. Patient sits with arm resting at side
  2. Shoulder externally rotated
  • 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
  • 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
  • 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]