866 A Lateral Approach Is More Likely to Be Successful Than A Posterior Approach for An Injection to Reach the Subacromial Space. (4th May 2021)

• Record Type: Journal Article
• Authors: Cheyne, N; Jeelani, A; Zeiton, M; Tablot, C; Holt, E; Jain, N
• Is Part Of: British journal of surgery. Volume 108(2021)Supplement 2
• Publication Date: 2021-05-04
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab134.331
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: Subacromial injections are common for diagnosis and therapy of shoulder impingement secondary to subacromial bursitis. We evaluated the likelihood of a successful subacromial injection from both the posterior and lateral injection sites. Method: We reviewed 100 MRI scans of the shoulder and recorded measurements in both the sagittal (representative of posterior injection) and coronal (representative of lateral injection) orientations. We compared these to the lengths of standard needles. Multiple measurements were taken: the shortest possible distance from the skin for the needle to reach under the nearest point of the acromion; along the angle of the acromion from the skin to the farthest point; the mid-point; the nearest point of the acromion. Results: Measuring along the angle of the acromion demonstrated shorter mean distances from the lateral injection site. The distance from skin to mid-point of the acromion) provided mean values of 51.4mm for posterior and 40.1mm for lateral. A standard 40mm (green) needle would reach the midpoint of the acromion in 58% of lateral measurements and 23% from posterior. Conclusions: Injections are more likely to enter the subacromial space from a lateral rather than a posterior entry point.