Shoulder Subacromial Injection Questions & Answers

1. Meislin RJ, Sperling JW, Stitik TP. Persistent shoulder pain: epidemiology, pathophysiology, and diagnosis. Am J Orthop (Belle Mead NJ). 2005 Dec. 34 (12 Suppl):5-9. [QxMD MEDLINE Link].

2. Peripheral joint, soft tissue and spinal injection technique. Braddom RL, ed. Physical Medicine and Rehabilitation. 3rd ed. Philadelphia: Elsevier; 2007. Chap 25.

3. Shoulder. Armstrong AD, Hubbard MC, eds. Essentials of Musculoskeletal Care. 5th ed. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2016. Section 2.

4. Stephens MB, Beutler AI, O'Connor FG. Musculoskeletal injections: a review of the evidence. Am Fam Physician. 2008 Oct 15. 78 (8):971-6. [QxMD MEDLINE Link].

5. Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore). 2015 Mar. 94 (10):e510. [QxMD MEDLINE Link].

6. Lee JH, Lee SH, Song SH. Clinical effectiveness of botulinum toxin type B in the treatment of subacromial bursitis or shoulder impingement syndrome. Clin J Pain. 2011 Jul-Aug. 27 (6):523-8. [QxMD MEDLINE Link].

7. Çift H, Özkan FÜ, Tolu S, Şeker A, Mahiroğulları M. Comparison of subacromial tenoxicam and steroid injections in the treatment of impingement syndrome. Eklem Hastalik Cerrahisi. 2015. 26 (1):16-20. [QxMD MEDLINE Link].

8. Aksakal M, Ermutlu C, Özkaya G, Özkan Y. Lornoxicam injection is inferior to betamethasone in the treatment of subacromial impingement syndrome : A prospective randomized study of functional outcomes. Orthopade. 2017 Feb. 46 (2):179-185. [QxMD MEDLINE Link].

9. Shams A, El-Sayed M, Gamal O, Ewes W. Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears. Eur J Orthop Surg Traumatol. 2016 Dec. 26 (8):837-842. [QxMD MEDLINE Link].

10. von Wehren L, Blanke F, Todorov A, Heisterbach P, Sailer J, Majewski M. The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2016 Dec. 24 (12):3787-3792. [QxMD MEDLINE Link].

11. Jones A, Regan M, Ledingham J, Pattrick M, Manhire A, Doherty M. Importance of placement of intra-articular steroid injections. BMJ. 1993 Nov 20. 307 (6915):1329-30. [QxMD MEDLINE Link]. [Full Text].

12. Eustace JA, Brophy DP, Gibney RP, Bresnihan B, FitzGerald O. Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis. 1997 Jan. 56 (1):59-63. [QxMD MEDLINE Link]. [Full Text].

13. Cunnington J, Marshall N, Hide G, Bracewell C, Isaacs J, Platt P, et al. A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis. Arthritis Rheum. 2010 Jul. 62 (7):1862-9. [QxMD MEDLINE Link]. [Full Text].

14. Blair B, Rokito AS, Cuomo F, Jarolem K, Zuckerman JD. Efficacy of injections of corticosteroids for subacromial impingement syndrome. J Bone Joint Surg Am. 1996 Nov. 78 (11):1685-9. [QxMD MEDLINE Link].

15. Aly AR, Rajasekaran S, Ashworth N. Ultrasound-guided shoulder girdle injections are more accurate and more effective than landmark-guided injections: a systematic review and meta-analysis. Br J Sports Med. 2015 Aug. 49 (16):1042-9. [QxMD MEDLINE Link].

16. Page MJ, Green S, McBain B, Surace SJ, Deitch J, Lyttle N, et al. Manual therapy and exercise for rotator cuff disease. Cochrane Database Syst Rev. 2016 Jun 10. CD012224. [QxMD MEDLINE Link].

17. Molini L, Mariacher S, Bianchi S. US guided corticosteroid injection into the subacromial-subdeltoid bursa: Technique and approach. J Ultrasound. 2012 Feb. 15 (1):61-8. [QxMD MEDLINE Link]. [Full Text].

18. Rutten MJ, Maresch BJ, Jager GJ, de Waal Malefijt MC. Injection of the subacromial-subdeltoid bursa: blind or ultrasound-guided?. Acta Orthop. 2007 Apr. 78 (2):254-7. [QxMD MEDLINE Link]. [Full Text].

Brett J Rothaermel, MD, PT Clinical Instructor, Department of Physical Medicine and Rehabilitation, Louisiana State University School of Medicine; Clinical Lead, Southeast Louisiana Veterans Healthcare System

Brett J Rothaermel, MD, PT is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Louisiana State Medical Society

Disclosure: Nothing to disclose.

Steven S Morrison, Jr, MD Resident Physician, Department of Physical Medicine and Rehabilitation, Louisiana State University School of Medicine in New Orleans

Steven S Morrison, Jr, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Laurie Scudder, DNP, NP Nurse Planner, Medscape; Senior Clinical Professor of Nursing, George Washington University

Disclosure: Nothing to disclose.

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Medscape Drugs & Diseases thanks James R Verheyden, MD, Consulting Surgeon, Department of Orthopedic Surgery, The Orthopedic and Neurosurgical Center of the Cascades, for assistance with the video contribution to this article.

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