Musculoskeletal Medicine and PainORIGINAL ARTICLE

Ultrasound-guided injection through the rotator cuff interval: a clinical perspective of one institution’s results and description of technique

Nahum M. Beard, MD, CAQSM; Luke Beggs, PhD, MD; William G. Murphy, MD; Margaret Knack, RN, BSN, MS, CCRP; Owen Golden, MS, ATC; and William Ross, MD
Notes and Affiliations
Notes and Affiliations

Received: June 8, 2023

Accepted: June 19, 2023

Published: August 18, 2023

  • Nahum M. Beard, MD, CAQSM, 

    Department of Orthopaedic Surgery and Biomedical Engineering, The University of Tennessee Health Science Center—Campbell Clinic, Memphis, TN, USA

  • Luke Beggs, PhD, MD, 

    Department of Orthopaedic Surgery and Biomedical Engineering, The University of Tennessee Health Science Center—Campbell Clinic, Memphis, TN, USA

  • William G. Murphy, MD, 

    Department of Orthopaedic Surgery and Biomedical Engineering, The University of Tennessee Health Science Center—Campbell Clinic, Memphis, TN, USA

  • Margaret Knack, RN, BSN, MS, CCRP, 

    Campbell Clinic Foundation, Germantown, TN, USA

  • Owen Golden, MS, ATC, 

    Department of Orthopaedic Surgery and Biomedical Engineering, The University of Tennessee Health Science Center—Campbell Clinic, Memphis, TN, USA

  • William Ross, MD, 

    University of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA

J Osteopath Med; 123(12): 571-576
Abstract

Context: Fluoroscopic injection through the rotator cuff interval (RCI) is a common technique for diagnostic arthrography and therapeutic intervention. Ultrasound approaches through the RCI have been less commonly studied, but there is a growing body of literature.

Objectives: The purpose of this study was to present a standardized technique of ultrasound-guided injection into the glenohumeral joint utilizing the RCI in magnetic resonance imaging (MRI) arthrography (MRA) and to report one medical group’s experience with the technique.

Methods: A retrospective chart review of all ultrasound-guided injections into the glenohumeral joint utilizing the RCI was performed from July 1, 2014 through June 1, 2021. Data were compiled for age, gender, body mass index (BMI), and prior surgery on the shoulder. The primary endpoint was successful administration of intra-articular dilute gadolinium contrast adequate for radiologic interpretation. A total of 487 injections into the glenohumeral joint via the RCI were performed. One hundred and fifty-five patients had previous shoulder surgery, with the remainder naive to intervention.

Results: The success rate of injections into the glenohumeral joint was 99.4 %, with only three injections considered unsuccessful. The three unsuccessful injections did not succeed because of a lack of intra-articular contrast media present. This success rate is impressive and promising, particularly when considering that 155 of the patients had previous surgery, which could potentially cause complications, and because these injections were performed over a long period of 7 years.

Conclusions: Accessing the RCI under ultrasound guidance is a very successful technique for injection within the glenohumeral joint.

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