Gopinath Duraiswamy1, Vishesh Khanna2, Prabhudev Prasad3, Senthil N Sambandam3, Varatharaj Mounasamy4. 1. K.G. Hospital and Post Graduate Medical Institute, Arts College Road, Coimbatore, 641018, Tamil Nadu, India. 2. Wrightington Hospital, WWL NHS Trust, United Kingdom. 3. Boston VA Medical Centre, 150 S Huntington Avenue, Boston, MA, 02130, USA. 4. VCU Medical Center Ambulatory Care Center, Virginia, USA.
Abstract
BACKGROUD: the ideal route and accuracy of subacromial injections in shoulder pathologies are often questioned. This study aimed at comparing anterior and posterior injections in terms of subacromial space dye localization and diagnostic accuracy. We hypothesized that posterior injections would prove more accurate. METHODS: lidocaine-dye mix was injected posteriorly and anteriorly in five cadaveric shoulders each. Presence of dye was ascertained at dissection. RESULTS: All five posterior injections remained confined to the subacromial space. In all five anteriorly injected shoulders, the dye was seen leaking from the subacromial space into bicipital groove. CONCLUSIONS: Varying accuracies of anterior [69-90%] and posterior [56-80%] subacromial injections have been reported. We observed both routes to be equally accurate [100%]. The dye exclusively remained within the subacromial space with posterior injections. This has higher diagnostic value in differentiating subacromial and long head of biceps pathologies. The anterior approach may have a better therapeutic role in combined subacromial and biceps pathologies.
BACKGROUD: the ideal route and accuracy of subacromial injections in shoulder pathologies are often questioned. This study aimed at comparing anterior and posterior injections in terms of subacromial space dye localization and diagnostic accuracy. We hypothesized that posterior injections would prove more accurate. METHODS: lidocaine-dye mix was injected posteriorly and anteriorly in five cadaveric shoulders each. Presence of dye was ascertained at dissection. RESULTS: All five posterior injections remained confined to the subacromial space. In all five anteriorly injected shoulders, the dye was seen leaking from the subacromial space into bicipital groove. CONCLUSIONS: Varying accuracies of anterior [69-90%] and posterior [56-80%] subacromial injections have been reported. We observed both routes to be equally accurate [100%]. The dye exclusively remained within the subacromial space with posterior injections. This has higher diagnostic value in differentiating subacromial and long head of biceps pathologies. The anterior approach may have a better therapeutic role in combined subacromial and biceps pathologies.
Authors: Michael N Kang; Louis Rizio; Michael Prybicien; David A Middlemas; Marcia F Blacksin Journal: J Shoulder Elbow Surg Date: 2008 Jan-Feb Impact factor: 3.019
Authors: Douglas P Beall; Eric E Williamson; Justin Q Ly; Mark C Adkins; Robert L Emery; Thomas P Jones; Charles M Rowland Journal: AJR Am J Roentgenol Date: 2003-03 Impact factor: 3.959
Authors: Vamsi M Singaraju; Richard W Kang; Adam B Yanke; Allison G McNickle; Paul B Lewis; Vincent M Wang; James M Williams; Susan Chubinskaya; Anthony A Romeo; Brian J Cole Journal: J Shoulder Elbow Surg Date: 2008-09-10 Impact factor: 3.019