The Shoulder

Technique:

• The patient sits in the same position as described for palpation.
• Palpation of joint line and ligaments.
• Localisation of the painful area.
• The needle is inserted at the centre of the painful area and aimed at the clavicular side of the joint ( 1 ).
• The infiltration is linewise: about half of the product is injected by a series of partial withdrawals and reinsertions of the needle while depositing small droplets into the ligament each time.
• The ligament lies superficial to the bone, so the needle should have its tip in bony contact with each deposit.
• The needle is then partly removed and aimed at the acromial side of the joint line (2) where the same procedure of infiltration is repeated: small infiltrations with the needle in bony contact.