title: Indirect ultrasound guidance increased accuracy of the glenohumeral injection using the superior approach: a cadaveric study of injection accuracy.
abstract: OBJECTIVE
  To investigate whether or not indirect ultrasound guidance could increase the accuracy of the glenohumeral joint injection using the superior approach.
  
  
  METHODS
  Twelve shoulders from 7 adult cadavers were anatomically dissected after a dye injection had been performed, while the cadavers were in the supine position. Before the injection, a clinician determined the injection point using the ultrasound and the more internal axial arm rotation was compared to how it was positioned in a previous study. Injection confidence scores and injection accuracy scores were rated.
  
  
  RESULTS
  The clinician's confidence score was high in 92% (11 of 12 shoulders) and the injection accuracy scores were 100% (12 of 12 shoulders). The long heads of the biceps tendons were not penetrated.
  
  
  CONCLUSIONS
  Indirect ultrasound guidance and positioning shoulder adducted at 10° and internally rotated at 60°-70° during the superior glenohumeral joint injection would be an effective method to avoid damage to the long head of biceps tendons and to produce a highly accurate injection.
authors.affiliation: Department of Physical Medicine and Rehabilitation, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
authors.forename: Joon Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Min-Wook
authors.initials: MW
authors.lastname: Kim
authors.forename: Dong Yoon
authors.initials: DY
authors.lastname: Park
keywords: Cadaver; Injections; Shoulder; Superior; Ultrasound