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Ann Rehabil Med 2013 Apr; 37(2): 202-207
Indirect Ultrasound Guidance Increased Accuracy of the Glenohumeral Injection Using the Superior Approach: A Cadaveric Study of Injection Accuracy
Joon Sung Kim, MD, Min-Wook Kim, MD, Dong Yoon Park, MD
Department of Physical Medicine and Rehabilitation, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective To investigate whether or not indirect ultrasound guidance could increase the accuracy of the glenohumeral joint injection using the superior approach.
Methods Twelve shoulders from 7 adult cadavers were anatomically dissected after a dye injection had been performed, while the cadavers were in the supine position. Before the injection, a clinician determined the injection point using the ultrasound and the more internal axial arm rotation was compared to how it was positioned in a previous study. Injection confidence scores and injection accuracy scores were rated.
Results The clinician's confidence score was high in 92% (11 of 12 shoulders) and the injection accuracy scores were 100% (12 of 12 shoulders). The long heads of the biceps tendons were not penetrated.
Conclusion Indirect ultrasound guidance and positioning shoulder adducted at 10° and internally rotated at 60°—70° during the superior glenohumeral joint injection would be an effective method to avoid damage to the long head of biceps tendons and to produce a highly accurate injection.
Shoulder, Injections, Ultrasound, Superior, Cadaver
Ann Rehabil Med 2013 Apr; 37(2): 202-207

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