The Shoulder

Technique:

• The patient lies supine, the arm abducted to 90° and in slight lateral rotation.
• The elbow is flexed to a right angle. An assistant holds the elbow and the lower arm.
• The bicipital groove can easily be felt between the lesser and the major tubercle .
• Also the antero-lateral acromial border and the coraco-acromial ligament are palpated.
• A 2 ml syringe is filled with 20 mg triamcinolone and a 5 cm needle is fitted to it.
• The needle is inserted between both humeral tuberosities, parallel to the bicipital sulcus and aimed at the palpating finger on the coraco-acromial ligament.
• It is moved further in under the palpating finger until a tough resistance is felt.
• The steroid is infiltrated here carefully so to treat the whole insertion.
• During the infiltration, counter-pressure is felt on the plunger.