Diagnostic injection around the shoulder: Hit and miss? A cadaveric study of injection accuracy

Partington, Paul; Broome, G.

doi:10.1016/s1058-2746(98)90226-9

Cited by 110 publications

(71 citation statements)

References 4 publications

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“…3 Unfortunately, AC joint injections can be challenging and up to one-third of injections have been shown to be outside the joint. 17 I did not perform radiographic guidance of our injection site. Instead, local anaesthetic was injected and its anaesthetic effect was measured using the previously described protocol of clinical testing.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: A new test for acromio-clavicolar pathology

Saccomanni¹

2013

Journal of Clinical Orthopaedics and Trauma

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Section: Discussionmentioning

confidence: 99%

RETRACTED: A new test for acromio-clavicolar pathology

Saccomanni¹

2013

Journal of Clinical Orthopaedics and Trauma

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“…Another important concern in our study was the use of ultrasound to guide the subacromial injection from the anterolateral approach. Partington and Broome (26) found that, although injection into the subacromial space through an anterolateral approach ' was successful in more than 80% of cadaveric specimens in the absence of ultrasound guidance, 75% of the successful injections also infiltrated other regional structures, including the rotator cuff and deltoid. Both Chen et al (27) and Tagliafico et al (28) stated that greater accuracy was obtained when ultrasoundguided injections were used, as compared with blind injection.…”

Section: 'C>-t----------------------mentioning

confidence: 99%

Effect of Subacromial Injections of Hyaluronan on Different Grades of Rotator Cuff Lesion: A Prospective Study

et al. 2013

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Rotator cuff lesions are quite common and in some cases Hyaluronic Acid (HA) can playa role in pain relief and in restoring functions. The aim of the study was to point out the correct indications for HA injection therapy through a prospective study: firstly defining the safety and efficacy of HA in the different grades of cuff tears, then evaluating the maintenance at 90 days, as secondary endpoint. A prospective, open-label uncontrolled study was developed. One hundred patients diagnosed with different rotator cuff lesions were divided into 4 grade-related groups based on a modified Neer's classification. A cycle of3 US-guided injections of medium-low weight HA was performed through the anterolateral way, one every two weeks. Follow-up was at 0, 15,30,45 and 90 days. VAS, Oxford-Shoulder-Score (OSS) and Constant-Murley were used for evaluations. In grade I and II, at day 45, a significant reduction of VAS and increase of Constant-Murley and OSS resulted. In grade IV VAS slowly decreased in the first 45 days, while OSS and Constant did not improve significantly. In grade III patients had no benefit from a clinical and subjective point of view. At ninety days the beneficial effect was still maintained in grades I, II and rv. Overall, the treatment showed a high tolerability profile. In conclusion, patients affected by bursitis or partial cuff tears benefit from HA, while in cuff arthropathy HA might only delay surgery or represent a palliative. In complete tears HA was not effective in pain relief or functional recovery.Shoulder pain is common, with a reported prevalence of 3-6.9% in the general population and 21% in those over 70 years of age (1), and shoulder disorders account for 1.2% of all visits to general practioners (2).Rotator cuff tendon tear is one of the most frequent painful condition in the shoulder and is the cause of degenerative changes in bone and muscles that modifies all the balance in the shoulder. It is in fact evolutive, leading to the so-called condition of cuff tear arthropathy or eccentric shoulder osteoarthritis. In such conditions, prior to any surgical indication, conservative treatments should be considered. Anti-inflammatory Drugs (NSAIDs), steroid oral administration or injections are still considered for an initial therapeutical approach (3, 4): however, they are affected by lots of adverse and side effects. In particular, intra-articular injections of steroids also expose patients to local adverse events: tendon atrophy, with fragmentation of collagen bundles and lost of the tensile properties (5). In these circumstances, hyaluronan (HA) (also referred to as hyaluronic acid or sodium hyaluronate) might have a novel role in the treatment of shoulder

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“…5,9,[12][13][14]46 One reason for such differences possibly can be related to variability in the accuracy of injected corticosteroid placement. For example, the success rate of blinded subacromial injection varied greatly from 29% to 83% depending on injection methods and operators, [47][48][49][50] with better treatment effect from corticosteroids more accurately injected into the subacromial bursa. 9,15,51 With recent advances in diagnostic ultrasound in musculoskeletal medicine, ultrasound-guided injections have become prevalent.…”

Section: Discussionmentioning

confidence: 99%

Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial

Hong

Moon

et al. 2011

Archives of Physical Medicine and Rehabilitation

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Shoulder pain accounts for 33.2% of physician office visits for musculoskeletal pain in the United States. The prevalence of shoulder pain is 7% to 27% for adults and is increasing for women and older individuals. The most frequent cause of shoulder pain is subacromial impingement syndrome (SIS), which includes a number of pathological entities: rotator cuff syndrome, tendonitis and bursitis in the shoulder. SIS occurs when the soft tissues of the glenohumeral joint between the coracoacromial arch and the humeral tuberosity are compressed, disturbing the normal slidingmechanism when elevating the arm. Current approaches to treat SIS include conservative management comprising rest (but not immobilization), ice packs, physiotherapy, or NSAIDS, or any combination of these approaches. In some cases, surgical treatment may be considered an option. Accreditation StatementThis journal-based activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the sponsorship of the Elsevier Office of Continuing Medical Education (EOCME). The EOCME is accredited by the ACCME to provide continuing medical education (CME) for physicians. Credit Designation StatementThe EOCME designates this journal-based activity for a maximum of 3.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other health care professionals completing continuing education credit for this activity will be issued a certificate of participation. Educational ObjectivesTo support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objective:1. Describe the evidence-base supporting the effectiveness of corticosteroid injections for subacromial impingement syndrome 2. Demonstrate their ability to develop a treatment plan based on current evidence Planning CommitteeJi Yeon Hong, MD, Seung-Hyun Yoon, MD, PhD, Do Jun Moon, MD, Kyu-Sung Kwack, MD, PhD, Bohyun Joen, MD, Hyun Young Lee, MS, Tania Dickson, PhD. Faculty Profiles & Disclosure InformationAs a sponsor accredited by the ACCME, it is the policy of the EOCME to require the disclosure of anyone who is in a position to control the content of an educational activity. All relevant financial relationships with any commercial interests and/or manufacturers must be disclosed to participants at the beginning of each activity. The faculty of this educational activity discloses the following: JI YEON HONG, MD Department of Physical Medicine and RehabilitationAjou University School of Medicine and Ajou University Hospital, Suwon Republic of Korea Disclosures: Has nothing to disclose. SEUNG-HYUN YOON, MD, PhD Department of Physical Medicine and Rehabilitation Ajou University School of Medicine and Ajou University Hospital, SuwonRepublic of Korea Disclosures: Has nothing to disclose. DO JUN MOON, MDDepartment of Physical Medicine and Rehabilitation Goyang Healings Hospi...

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Diagnostic injection around the shoulder: Hit and miss? A cadaveric study of injection accuracy

Cited by 110 publications

References 4 publications

RETRACTED: A new test for acromio-clavicolar pathology

RETRACTED: A new test for acromio-clavicolar pathology

Effect of Subacromial Injections of Hyaluronan on Different Grades of Rotator Cuff Lesion: A Prospective Study

Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial

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