Should we continue to administer blind shoulder injections?

Creative Commons License

AĞIRMAN M., Leblebicier M. A., Durmuş O., Saral I., GÜNDÜZ O. H.

Eklem Hastaliklari ve Cerrahisi, vol.27, no.1, pp.29-33, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 27 Issue: 1
  • Publication Date: 2016
  • Doi Number: 10.5606/ehc.2016.06
  • Journal Name: Eklem Hastaliklari ve Cerrahisi
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.29-33
  • Keywords: Injection, intra-articular, pain, shoulder
  • Istanbul Medipol University Affiliated: Yes


Objectives: This study aims to investigate the accuracy and effectiveness of blind and fluoroscopic-guided intra-articular shoulder injections in patients with shoulder pain. Patients and methods: The study included 17 patients (6 males, 11 females; mean age 52.6±9.9 years; range 36 to 66 years) with shoulder pain more than three months. First intra-articular joint injections were performed with anterior approach blindly. Following the injection and after confirming that the needle tip was intra-articular with fluoroscopy and contrast distribution, the procedure was completed using 3 mL of local anesthetic (prilocaine and bupivacaine) and 1 mL of steroid (40 mg methylprednisolone). When the contrast distribution was observed to be extra-articular at the first administration, a second injection was continued under fluoroscopy guidance. All of the injections were intraarticular with the continuation of the procedure. Pain intensity was measured with visual analog scale (VAS). Results: According to the contrast distribution viewed with fluoroscopy, first blind injections were intra-articular in 11 of the 17 shoulders (64.7%). Mean of initial VAS score was 7.11. Improved pain was observed in the clinical follow-ups at the first hour (mean VAS: 2.35), third day (mean VAS: 2.64), and at the end of the first month (mean VAS: 2.23). The mean durations for blind and fluoroscopic-guided procedures excluding patients' preparation time were 0.8 minutes and 4.2 minutes, respectively. Conclusion: Although blind intra-articular shoulder injections are inexpensive and easily applicable, injections should be performed under fluoroscopy or another guide to ensure that the needle is intra-articular, not peri-articular.