Journal of Korean Society of Medical Ultrasound 2004;23(1): 41-45.
Steroid Injection for Painful Shoulder: Usefulness of Ultrasound-guided Approach.
Min Hee Lee
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea.
  Published online: March 1, 2004.
PURPOSE: To evaluate the efficacy of steroid injection into the subacromial bursa and biceps tendon sheath for painful shoulders and the usefulness of ultrasound-guided approach. MATERIALS AND METHODS: Seventeen shoulders of twelve patients with shoulder pain and limited motion were included, and these patient were clinically diagnosed as a painful arc syndrome. Under ultrasound guidance, steroid injection was performed into the subacormial bursa (13 cases) and biceps tendon sheath (4 cases). In 7 cases, 1 mL of steroid was used while the remaining six patients received a mixture of 1 mL of steroid and 1 ml of lidocaine. Both shoulders of two patients received 0.5 mL of steroid. The location of needle and injection duration of fluid were continuously monitored, and complications such as leakage of steroid were recorded. Medical records were reviewed for the presence of pain relief and increasing range of motion following the injection. RESULTS: On ultrasonogram, the needle within the subacromial bursa and biceps tendon sheath was seen as a linear echogenic structure, and injected fluid was identified. There was neither the leakage of steroid injection nor any other complications. In 16 (94%) of 17 shoulders, there was decreased intensity of shoulder pain while increased range of motion was noted in three patients following the injection. CONCLUSION: Steroid injection into the subacormial bursa and biceps tendon sheath is effective in treating shoulder pain and limted range of motion of the shoulder, and ultrasound is useful guiding method.
Keywords: Shoulder; Shoulder, US; Ultrasound (US), guidance
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