Successful injection of the acromioclavicular joint with use of ultrasound: anatomy, technique, and follow-up

Comparison of Varying Corticosteroid Type, Dose, and Volume for the Treatment of Pain in Small‐ and Intermediate‐Size Joint Injections: A Narrative Review

“…The other study showed that a 60‐mg dose of triamcinolone hexacetonide demonstrated clinically significant pain improvements for at least 1 month . Only one study, a prospective cohort study, met the inclusion criteria for the acromioclavicular (AC) joint; it demonstrated that 40 mg of injected methylprednisolone acetate resulted in a clinically and statistically significant improvement in pain at all time points up to 6 months when excluding those with concomitant rotator cuff symptoms . A single study (cohort) examined the ankle joint, with clinically and statistically significant improvement in pain for at least a month .…”

“…20 Only one study, a prospective cohort study, met the inclusion criteria for the acromioclavicular (AC) joint; it demonstrated that 40 mg of injected methylprednisolone acetate resulted in a clinically and statistically significant improvement in pain at all time points up to 6 months when excluding those with concomitant rotator cuff symptoms. 32 A single study (cohort) examined the ankle joint, with clinically and statistically significant improvement in pain for at least a month. 20 Finally, in a single study which combined foot (39% of joints injected) and ankle (61%) joints, an injection of approximately 45 mg of methylprednisolone acetate in each joint showed statistically significant Foot and Ankle Outcome Scores through 6 months, although the individual joints were not examined separately.…”

Ultrasonography Leads to Accurate Diagnosis and Management of Painful Acromioclavicular Joint Cyst

“…Ultrasound is superior to palpation alone for identification of ACJ anatomy and for needle guidance during interventional management. Blind intra‐articular ACJ injection has been estimated to be only 40% to 60% accurate . Edelson et al.…”

“…Blind intra-articular ACJ injection has been estimated to be only 40% to 60% accurate. 13 Edelson et al demonstrated a 96% injection success rate using ultrasound guidance with subsequent confirmation via arthrography. Furthermore, Peck et al 14 showed 100% accuracy with ultrasound-guided ACJ injection compared to only 40% with palpation-guided injection using cadaveric models.…”

Reply to the Letter to the Editor: Does the Use of Ultrasound Affect Contamination of Musculoskeletal Injections Sites?

“…The direct technique, however, requires the probe to be in constant, close proximity to the needle and thereby increases the likelihood of contamination of the injection site with transmission gel. This technique is commonly reported in the literature and most popular in our experience [2,4]. Although more challenging, this direct approach also allows for recording of images that demonstrates the location of the needle in the intended structure, which is often needed or at least helpful for appropriate procedure coding [3].…”