Chapter 47 Shoulder Injection—Subacromial Approach
Common indications
Corticosteroid injections can improve symptoms of osteoarthritis or inflammatory arthritis of the shoulder joint (Figure 47-1).
Equipment
The equipment includes gloves, povidone-iodine wipes or alcohol wipes, a 1½-in. 25- or 27-gauge needle, an 18-gauge needle and a 10-cc syringe, 1% lidocaine without epinephrine or 0.5% bupivacaine, 20 to 40 mg of methylprednisolone acetate or the equivalent, and an adhesive bandage dressing (Figure 47-2).
Key steps
1. As with all joint injections, sterility must be maintained for any components used in the injection that enters the joint space.
3. Thoroughly cleanse the shoulder with an antiseptic solution (Figure 47-3). Consider all of the possible diagnoses before proceeding with treatment. Do not inject steroids into a potentially infected shoulder joint.
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