Years ago, though they injected local in shoulder bursa, they injected the cortisone in the buttock and got the same results as injecting it it bursa. This study was ignored by people who wanted ultrasound to be better. Now, a randomized control trial did not find ultrasound versus landmark shoulder injection made any difference. Using US could be a lengthy procedure and I’m glad it is put to rest.
Journal of Clinical Orthopaedics and Trauma Volume 9, Supplement 1, March 2018, Pages S80-S85
Ultrasound guided versus landmark guided corticosteroid injection in patients with rotator cuff syndrome: Randomised controlled trial
Himanshu Bhayan et al
Lateral Subacromial Injection Technique:
- 10 ml syringe connected to 5 cm, 21 gauge needle was prepared with 2 ml of 40 mg/ml Methylprednisolone Acetate suspension mixed
- inserting the needle just inferior to the midlateral aspect of the acromion, with the needle angled slightly cephalad, passing through the deltoid muscle, and directed medially and slightly anterior to the subacromial bursa
- given 5 days antibiotics to prevent infection
Comment – cheated by using contrast dye and xrays but that alone cannot guarantee in subacromial plain. Still, no difference is encouraging.
They found adding exercises to injection improved results but did not elaborate.