초음파를 활용한 회전근개 간격으로 접근한 견관절 주사법
Ultrasound Guided Shoulder Joint Injection through Rotator Cuff Interval
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Background: Shoulder joint injection is currently performed under fluoroscopic or computed tomography scan guidance. We performed this study to determine if an ultrasound guided shoulder joint injection through rotator cuff interval would have clinical usefulness. Methods: A total of 17 volunteers [12 women, 5 men; mean age 28 yr (23−32 yr)] received shoulder joint injection under multilinear ultrasound (5−10 MHz). Volunteers were positioned supinely on a table with their arm in a neutral position. The anterior shoulder region of the patient was sterilized using povidone iodine. A 24 gauge needle was introduced and directly visualized in real time as it passed obliquely from the skin surface to the inferior space of the biceps tendon. If there was little or no resistance to the injection, a contrast media (omnipaque) was injected and checked fluoroscopically. Results: Ultrasound guided shoulder joint injection through rotator cuff interval was successful in all cases. The average time taken for the procedure was 27.5 ± 16.5 sec. The vertical distance from skin to the inferior space of the biceps tendon was 1.6 ± 0.4 cm and the distance of needle from the skin to the inferior space of biceps tendon was 2.8 ± 0.6 cm. The procedure was well tolerated by all volunteers. Conclusions: Ultrasound guided shoulder joint injection through rotator cuff interval is an effective, rapid, and easy-to-perform injection technique. Ultrasound guided injection enables exact needle placement and avoids the use of both ionizing radiation and iodinated contrast material.(Korean J Pain 2008; 21: 57−61)
Abstract
Background: Shoulder joint injection is currently performed under fluoroscopic or computed tomography scan guidance. We performed this study to determine if an ultrasound guided shoulder joint injection through rotator cuff interval would have clinical usefulness. Methods: A total of 17 volunteers [12 women, 5 men; mean age 28 yr (23−32 yr)] received shoulder joint injection under multilinear ultrasound (5−10 MHz). Volunteers were positioned supinely on a table with their arm in a neutral position. The anterior shoulder region of the patient was sterilized using povidone iodine. A 24 gauge needle was introduced and directly visualized in real time as it passed obliquely from the skin surface to the inferior space of the biceps tendon. If there was little or no resistance to the injection, a contrast media (omnipaque) was injected and checked fluoroscopically. Results: Ultrasound guided shoulder joint injection through rotator cuff interval was successful in all cases. The average time taken for the procedure was 27.5 ± 16.5 sec. The vertical distance from skin to the inferior space of the biceps tendon was 1.6 ± 0.4 cm and the distance of needle from the skin to the inferior space of biceps tendon was 2.8 ± 0.6 cm. The procedure was well tolerated by all volunteers. Conclusions: Ultrasound guided shoulder joint injection through rotator cuff interval is an effective, rapid, and easy-to-perform injection technique. Ultrasound guided injection enables exact needle placement and avoids the use of both ionizing radiation and iodinated contrast material.(Korean J Pain 2008; 21: 57−61)
참고문헌 (10)
- Eustace JA, "Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms", Ann Rheum Dis, 56, pp.59~63 (1997)
- Chung CB, "MR arthrography of the glenohumeral joint: a tailored approach", AJR Am J Roentgenol, 177, pp.217~9 (2001)
- Zwar RB, "Sonographically guided glenohumeral joint injection", AJR Am J Roentgenol, 183, pp.48~50 (2004)
- Jost B, "Anatomy and functional aspects of the rotator interval", J Shoulder Elbow Surg, 9, pp.336~41 (2000)
- Harryman DT 2nd, "The role of the rotator interval capsule in passive motion and stability of the shoulder", J Bone Joint Surg Am, 74, pp.53~66 (1992)
- Hazleman BL, "The painful stiff shoulder", Rheumatol Phys Med, 11, pp.413~21 (1972)
- Rizk TE, "Histocompatibility type and racial incidence in frozen shoulder", Arch Phys Med Rehabil, 65, pp.33~4 (1984)
- Steinbrocker O, "Frozen shoulder: treatment by local injections of depot corticosteroids", Arch Phys Med Rehabil, 55, pp.209~13 (1974)
- Homsi C, "Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool?", Skeletal Radiol, 35, pp.673~8 (2006)
- Lee JC, "Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation", Skeletal Radiol, 34, pp.522~7 (2005)