Ultrasound-Guided Glenohumeral Joint Injection Using the Posterior Approach.

Abstract

This feature is a unique combination of text (voice) and video that more clearly presents and explains procedures in musculoskeletal medicine. These videos will be available on the journal’s Website. We hope that this new feature will change and enhance the learning experience. No caption available. Video Gallery: To view the online video of these procedures, use your smartphone camera QR Reader App to scan and capture this QR Code or visit www.AJPMR.com to locate this digital video content. URL: http://journals.lww.com/ajpmr/Pages/videogallery.aspx?videoId=22&autoPlay=true Injection treatment to the glenohumeral joint is often needed to treat shoulder problems such as adhesive capsulitis.1,2 This can be done through blind palpation technique and fluoroscopic or musculoskeletal ultrasound guidance.3 In recent years, ultrasound has been proven to increase the accuracy of needle placement into the glenohumeral joint.4 Ultrasound is radiation free and offers real-time images in performing needle-guided injection procedures.5 Glenohumeral joint injection can be done using the anterior rotator interval approach or the posterior approach technique.4 Both techniques are generally well tolerated by the patients. However, it was shown that the posterior injection technique offers an easier and a more effective approach to the glenohumeral joint with less extravasation rate as compared with the anterior approach.4 The posterior approach also avoids the potential risk of accidental puncture or injection into the axillary neurovascular structures. A linear transducer of 5–12 MHz is usually used.6 This technique is often applied to inject corticosteroid for the treatment of frozen shoulder or contrast medium for computed tomography or magnetic resonance shoulder arthrography.6