Equipment
Aspiration or injection of soft tissues may be performed as an outpatient procedure and does not require specialized equipment. [3] The following necessary equipment is readily available:
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Needle, 25-27 gauge
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Syringe, 3-5 mL
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Triamcinolone acetonide injection, 40-80 mg
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Lidocaine 1% without epinephrine, 0.5-1 mL
Patient Preparation
Anesthesia
Most experienced physicians prefer to use topical ethyl chloride or no anesthetic at all.
Positioning
Have the patient sit with hands in the lap. Ask the patient to relax the shoulder and neck muscles. Locate and mark the humeral head and the lateral edge of the acromion. The point of entry is directly over the bicipital groove, located approximately 2.5-3.0 cm (~1.0-1.25 in.) caudal to the anterolateral edge of the acromion. The groove is palpable when the arm is passively rotated internally and externally as the examiner's fingers are over the anterolateral humeral head.
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Bicipital tendon.
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Injection in bicipital groove.
