Presentation
Rugby player. Physio resistant shoulder discomfort. ?SLAP tear. For MR arthrogram.
Patient Data
Posterior approach: I...
Posterior approach: Injection of contrast
A 22G 90mm Quincke needle is inserted and targets the inferomedial aspect of the humeral head. Iodinated contrast freely flows into the glenohumeral joint, contouring the superior humeral head.
Posterior approach: Post inj
Post injection, the glenohumeral joint is distended with fluid containing iodinated contrast. The axillary pouch is distended and fluid extends out along the long head of biceps tendon sheath.
Case Discussion
This case demonstrates a technically successful shoulder arthrogram injection. Posterior shoulder/ glenohumeral injections for both MR arthrogram and anesthetic arthrogram injections will use the same technique, just different injectates.
The final end point of inserting the needle should contact bone so will feel be an end point.