The Shoulder

Technique:

• The patient is in a half-lying position, the arm in neutral position along the body.
• The shoulder is shrugged - to take the coracoid process away from the top of the lung - and slightly adducted.
• Lung and coracoid process are identified.
• The needle is inserted at about two cm below the tip of the coracoid process. The needle is then moved in a medial - cranial - and dorsal direction, aiming at the base of the coracoid process. It hits bone after 3 to 4 cm.
• It is then withdrawn for about 0.5 to 1 cm and the triamcinolone is infiltrated with withdrawals and reinsertions.