Ultrasound-Guided Shoulder Joint and Bursa Injections

  • Michael P. Schaefer
  • Kermit Fox


Shoulder pain is commonly encountered in pain management practices. Although the rotator cuff and the subacromial structures are thought to contribute to the majority of shoulder pain presentations, there are a number of other structures that generate pain. Fortunately, all these structures are easily accessible with office-based procedures, and injections are useful to confirm the diagnosis and provide analgesia.


Rotator Cuff Humeral Head Glenohumeral Joint Biceps Tendon Supraspinatus Tendon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Smith J, Finnoff J. Diagnostic and interventional musculoskeletal ultrasound: part 2. Clinical applications. PMR. 2009;1:162–177.Google Scholar
  2. 2.
    Jacobson J. Fundamentals of Musculoskeletal Ultrasound (p.75–79 for rotator cuff), and (p.87–91 for paralabral cyst). Philadelphia: Saunders; 2007.Google Scholar
  3. 3.
    Adler RS, Allan A. Percutaneous ultrasound guided injections in the shoulder. Tech Shoulder Elbow Surg. 2004;5(2):122–133.CrossRefGoogle Scholar
  4. 4.
    Huber DJ, Sauter R, Mueller E, Requardt H, Weber H. MR imaging of the normal shoulder. Radiology. 1986;158:405–408.PubMedGoogle Scholar
  5. 5.
    Chandnani VP, Yeager TD, DeBerardino T, et al. Glenoid labral tears: prospective evaluation with MRI imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. 1993;161:1229–1235.PubMedGoogle Scholar
  6. 6.
    Balasubramaniam P, Prathap K. The effect of injection of hydrocortisone into rabbit calcaneal tendons. J Bone Joint Surg Br. 1972;54–B:729–734.Google Scholar
  7. 7.
    Ford LT, DeBender J. Tendon rupture after local steroid injection. South Med J. 1979;72:827–830.PubMedCrossRefGoogle Scholar
  8. 8.
    Gottlieb NL, Riskin WG. Complications of local corticosteroid injections. JAMA. 1980;243:1547–1548.PubMedCrossRefGoogle Scholar
  9. 9.
    Shrier I, Matheson GO, Kohl HW. Achilles tendonitis: are corticosteroid injections useful or harmful? Clin J Sport Med. 1996;6:245–250.PubMedCrossRefGoogle Scholar
  10. 10.
    Unverferth LJ, Olix ML. The effect of local steroid injections on tendon. J Sports Med. 1973;1:31–37.PubMedGoogle Scholar
  11. 11.
    Grassi W, Farina A, Filippucci E, et al. Sonographically guided procedures in rheumatology. Semin Arthritis Rheum. 2001;30:347–353.PubMedCrossRefGoogle Scholar
  12. 12.
    Sofka CM, Collins AJ, Adler RS. Use of ultrasonographic guidance in interventional musculoskeletal procedures: a review from a single institution. J Ultrasound Med. 2001;20:21–26.PubMedGoogle Scholar
  13. 13.
    Van Holsbeeck M, Strouse PJ. Sonography of the shoulder: evaluation of the subacromial-­subdeltoid bursa. AJR Am J Roentgenol. 1993;160:561–564.PubMedGoogle Scholar
  14. 14.
    McGee D. Orthopedic Physical Assessment. 5th ed. Philadelphia: Saunders; 2008:293–294, 312.Google Scholar
  15. 15.
    Eustace JA, Brophy DP, Gibney RP, Bresnihan B, FitzGerald O. Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis. 1997;56:59–63.PubMedCrossRefGoogle Scholar
  16. 16.
    Partington PF, Broome GH. Diagnostic injection around the shoulder: hit and miss? A cadaveric study of injection accuracy. J Shoulder Elbow Surg. 1998;7:147–150.PubMedCrossRefGoogle Scholar
  17. 17.
    Yamakado K. The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation. Arthroscopy. 2002;18:887–891.PubMedCrossRefGoogle Scholar
  18. 18.
    Kang MN, Rizio L, Prybicien M, et al. The accuracy of subacromial corticosteroid injections: a comparison of multiple methods. J Shoulder Elbow Surg. 2008;17(suppl):61S–66S.PubMedCrossRefGoogle Scholar
  19. 19.
    Henkus HE, Cobben LP, Coerkamp EG, et al. The accuracy of subacromial injections: a prospective randomized magnetic resonance imaging study. Arthroscopy. 2006;22:277–282.PubMedCrossRefGoogle Scholar
  20. 20.
    Farin PU, Rasanen H, Heikki J, Arvi H. Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skeletal Radiol. 1996;25:551–554.PubMedCrossRefGoogle Scholar
  21. 21.
    Weiss J, Ting M. Arthrography-assisted intra-articular injection of steroids in treatment of ­adhesive capsulitis. Arch Phys Med Rehabil. 1978;59:285–287.PubMedGoogle Scholar
  22. 22.
    Sethi PM, Kingston S, Elattrache N. Accuracy of anterior intra-articular injection of the ­glenohumeral joint. Arthroscopy. 2005;21:77–80.PubMedCrossRefGoogle Scholar
  23. 23.
    Jones A, Regan M, Ledingham J, et al. Importance of placement of intraarticular steroid ­injections. BMJ. 1993;307:1329–1330.PubMedCrossRefGoogle Scholar
  24. 24.
    Rutten MJ, Collins JM, Maresch BJ, et al. Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography. Eur Radiol. 2009;19:722–730.PubMedCrossRefGoogle Scholar
  25. 25.
    Lim JB, Kim YK, Kim SW, Sung KW, Jung I, Lee C. Ultrasound guided shoulder joint injection through rotator cuff interval. Korean J Pain. 2008;21(1):57–61.CrossRefGoogle Scholar
  26. 26.
    Christensen RA, Van Sonnenberg E, Casola G, et al. Interventional ultrasound in the musculoskeletal system. Radiol Clin North Am. 1988;26:145–156.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Metro Health Rehabilitation Institute of OhioCase Western Reserve UniversityClevelandUSA

Personalised recommendations