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  • 張凱閔醫 花蓮2023!04!16Shoulder Injection

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    tsungyuchi
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    The document discusses ultrasound guided injections for various structures in the shoulder that can cause pain, including the biceps tendon, acromioclavicular joint, subacromial bursa, glenohumeral joint, and suprascapular nerve. It provides images showing the anatomy and needle placement for different shoulder injections. The document also summarizes prognostic factors for initial effectiveness of ultrasound guided subacromial injections and the potential for recurrence of shoulder pain.

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    The document discusses ultrasound guided injections for various structures in the shoulder that can cause pain, including the biceps tendon, acromioclavicular joint, subacromial bursa, glenohumeral joint, and suprascapular nerve. It provides images showing the anatomy and needle placement for different shoulder injections. The document also summarizes prognostic factors for initial effectiveness of ultrasound guided subacromial injections and the potential for recurrence of shoulder pain.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    3 views9 pages

    張凱閔醫 花蓮2023!04!16Shoulder Injection

    Uploaded by

    tsungyuchi
    The document discusses ultrasound guided injections for various structures in the shoulder that can cause pain, including the biceps tendon, acromioclavicular joint, subacromial bursa, glenohumeral joint, and suprascapular nerve. It provides images showing the anatomy and needle placement for different shoulder injections. The document also summarizes prognostic factors for initial effectiveness of ultrasound guided subacromial injections and the potential for recurrence of shoulder pain.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 9

    2023/3/24

    Ultrasound Guided Injection for Shoulders


    When Patients  Biceps tendon
    Have Shoulder Pain  Acromioclavicular joint
     Subacromial bursa
     Glenohumeral joint
    Ke-Vin Chang  Suprascapular nerve
    MD, PhD, CIPS, RMSK, ASRA-PMUC  Axillary nerve
    National Taiwan University Hospital, Bei-
    Ultrasound-Guided Interventions for Painful Shoulder: From Anatomy
    Hu Branch to Evidence. Chang et al. Journal of Pain Research 2018.

    Lateral Posterior Lateral

    Deltoid
    *
    Subscapularis
    Humeral
    Head
    * Greater
    Tuberosity
    * Lesser
    Tuberosity

    Biceps tendon
    3 4

    Cranial Lateral

    Deltoid
    Deltoid

    *
    * * *
    Humerus

    5 6

    1
    2023/3/24

    Lateral
    Acromioclavicular joint

    * *

    7 8

    Lateral Lateral

    *
    *
    * *
    Clavicle
    *
    Acromion Clavicle
    Acromion

    Humeral Head Supraspinatus

    9 10

    Posterior

    * *
    * *

    Supraspinatus
    11 12

    2
    2023/3/24

    Lateral
    Subacromial-subdeltoid bursa Lateral

    Deltoid

    Acromion
    Supraspinatus

    Humeral Head

    Humeral
    Deltoid

    Head

    13 14

    Lateral

    Deltoid
    Acromion

    Supraspinatus

    Humeral Head

    15 16

    2016

    Prediction of Initial Effectiveness of US


    Guided Subacromial Injection

    Good Prognostic Factor


    Right handedness
    Grade 2 subacromial impingement
    Bicipital groove tenderness

    Poor Prognostic Factor


    Subdeltoid bursitis
    Grade 3 subacromial impingement
    Shoulder stiffness

    3
    2023/3/24

    SD = Subdeltoid Bursitis

    Recurrence 20

    21 22

    4
    2023/3/24

    Lateral Lateral
    Glenohumeral Joint

    Coracoid
    Humeral Supraspinatus
    Head

    Scapula
    Subscapualris

    27 28

    Lateral Lateral

    Deltoid
    Capsule

    Coracoid
    Humeral
    Head Humeral
    Head

    29 30

    5
    2023/3/24

    Lateral Lateral

    Acromion Deltoid
    Trapezius

    Supraspinatus Infraspinatus

    Humeral Humeral L
    Head Head
    31 32

    33 34

    35 36

    6
    2023/3/24

    Lateral Suprascapular nerve

    Omohyoid

    37 38

    Lateral Lateral

    * * *
    Supraspinatus
    Fossa

    **

    Infraspinatus
    Fossa

    39
    Infraspinatus 40

    Lateral Lateral

    Trapezius

    Brachial
    Plexus
    Supraspinatus

    Serratus Anterior

    Intercostal Muscle
    ***
    41 42

    7
    2023/3/24

    Lateral

    Deltoid

    Infraspinatus

    Humeral L
    Head

    43 44

    Medial Axillary nerve

    Infraspinatus Deltoid

    45

    48

    8
    2023/3/24

    Anterior Cranial

    Deltoid

    Teres Major

    Teres Minor Triceps

    Humeral Head
    49 50

    Posterior

    Deltoid

    Triceps
    Humerus
    51 52

    kvchang011@gmail.com

    53

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