The Shoulder

Infiltration

At least one infiltration should be undertaken to confirm the diagnosis.

Material
A 10 cc syringe, filled with 0.5 % procaine, fitted to a thin 4-5cm needle

Technique

The patient sits. The arm is abducted to 90° and rests on a couch.
Keep the palpating thumb at the angle between clavicle and acromion.
Insert the needle in the supraspinous fossa, about three cm medial of the palpating thumb and move it further in a distal and lateral direction. The fluid is infiltrated deeply, in the fossa and under the posterior part of the AC joint.

After treatment:

Relative rest during a few days
If the infiltration confirms the diagnosis, the patient is referred for deep transverse frictions