Ultrasound Guided Shoulder Joint Injection through Rotator Cuff Interval

Background: Shoulder joint injection is currently performed under fluoroscopic or computed tomography scan guidance. We performed this study to determine if an ultrasound guided shoulder joint injection through rotator cuff interval would have clinical usefulness. Methods: A total of 17 volunteers [12 women, 5 men; mean age 28 yr (23−32 yr)] received shoulder joint injection under multilinear ultrasound (5−10 MHz). Volunteers were positioned supinely on a table with their arm in a neutral position. The anterior shoulder region of the patient was sterilized using povidone iodine. A 24 gauge needle was introduced and directly visualized in real time as it passed obliquely from the skin surface to the inferior space of the biceps tendon. If there was little or no resistance to the injection, a contrast media (omnipaque) was injected and checked fluoroscopically. Results: Ultrasound guided shoulder joint injection through rotator cuff interval was successful in all cases. The average time taken for the procedure was 27.5 ± 16.5 sec. The vertical distance from skin to the inferior space of the biceps tendon was 1.6 ± 0.4 cm and the distance of needle from the skin to the inferior space of biceps tendon was 2.8 ± 0.6 cm. The procedure was well tole rated by all volunteers. Conclusions: Ultrasound guided shoulder joint injection through rotator cuff interval is an effective, rapid, and easy-to-perform injection technique. Ultrasound guided injection enables exact needle placement and avoids the use of both ionizing radiation and iodinated contrast material. (Korean J Pain 2008; 21: 57−61)