Shoulder Injection

The subacromial bursa is another location frequently treated with steroid injection for bursitis or tendonitis. Injections of 10 to 20 mg of triamcinolone with 2 to 4 mL of lidocaine can be performed into the subacromial bursa. The easiest approach to the subacromial space is with the patient seated comfortably and arms resting at the side. The lateral shoulder is prepared with a sterile solution after palpating landmarks. The acromial process is identified on the lateral shoulder above the humeral head. In the sulcus between the humeral head and the acromial process lies the subacromial bursa. Marking the lateral border of the acromial process can provide some assistance. A 22- to 25-gauge needle on a syringe with the injection is then aimed directly into the sulcus between the bones 1 cm below the acromial process perpendicularly through the deltoid muscle. Ligamentous or muscular structures will resist injection, but the bursa should allow free infusion. Relief of pain may be noted in a few minutes if lidocaine is used and confirms the injection was placed appropriately. (See Tuggy Video: Joint Injection—Shoulder.)

Procedural training and videos.

Procedural education and videos.

Information on additional procedures, including those covered in this chapter

Excellent patient education materials.


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