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Accuracy and Dispersal of Subacromial and Glenohumeral Injections in Cadavers
NIGEL HANCHARD, DONAL SHANAHAN, TRACEY HOWE, JONATHAN THOMPSON, and LORNA GOODCHILD ABSTRACT. Objective. "Blind" shoulder injections are often inaccurate and infiltrate untargeted structures. We tested a hypothesis that optimizing certain anatomical and positional factors would improve accuracy and reduce dispersal. Methods. We evaluated one subacromial and one glenohumeral injection technique on cadavers. Results. Mean accuracy was 91% for subacromial-targeted and 74 and 91% (worst- and best-case scenarios) for joint-targeted injections. Mean dispersal was 19% for subacromial-targeted and 16% for joint-targeted injections. All results bettered those reported previously. Conclusion. These "optimized" techniques might improve accuracy and limit dispersal of blind shoulder injections in clinical situations, benefiting efficacy and safety. However, evaluation is required in a clinical setting. (J Rheumatol 2006;33:1143–6) Key Indexing Terms:
SHOULDER PAIN
From the Teesside Centre for Rehabilitation Sciences, University of Teesside, Middlesbrough; Department of Anatomy and Clinical Skills, School of Medical Education Development, University of Newcastle, Newcastle-upon-Tyne; Glasgow Caledonian University, Glasgow; Physiotherapy Department, York District Hospital, York; and Physiotherapy Department, The James Cook University Hospital, Middlesbrough, UK. Nigel Hanchard gratefully acknowledges the UK Department of Health for the fellowship award that funded this study. N.C.A. Hanchard, MSc, Department of Health Research Fellow, Teesside Centre for Rehabilitation Sciences, University of Teesside; D. Shanahan, PhD, Prosector, Department of Anatomy and Clinical Skills, School of Medical Education Development, University of Newcastle; T.E. Howe, PhD, Director, HealthQWest, Glasgow Caledonian University; J. Thompson, BSc (Hons), Extended Scope Practitioner of Physiotherapy, Physiotherapy Department, York District Hospital; L. Goodchild, BSc (Hons), Extended Scope Practitioner of Physiotherapy, Physiotherapy Department, The James Cook University Hospital. Address reprint requests to N. Hanchard, Teesside Centre for Rehabilitation Sciences (University of Teesside), The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK. E-mail: n.hanchard@tees.ac.uk Accepted for publication February 27, 2006.
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