Glenohumeral Joint Injection Under Ultrasound

Abstract

Glenohumeral joint injections are used to treat shoulder conditions such as subacromial bursitis, rotator cuff pathology, impingement, and adhesive capsulitis. They can also be used as diagnostic nerve blocks to differentiate between several types of pain generators in the shoulder. Though they have been successfully performed using anatomical landmarks and fluoroscopy, ultrasound is used more and more due to its real-time visualization, lack of radiation exposure, and near 100% accuracy when used to inject into the glenohumeral joint (Ogul et al., Clin Imaging 38(1):11–17, 2014; Zwar et al., AJR Am J Roentgenol 183(1):48–50, 2004). The injection can be performed via the anterior rotator interval or posterior approach. The posterior approach is preferred and will be described below as it is easier to perform, has decreased rates of extravasation, and avoids risking puncture of the axillary neurovascular structures (Ogul et al., Clin Imaging 38(1):11–17, 2014).

Complications of glenohumeral joint injections include septic arthritis, hemarthrosis, or inadvertent puncture of the labrum, long head of the biceps, articular cartilage, and surrounding neurovascular structures.