Joint injections are interventional treatment procedures that offer fast nutrient and drug delivery to help manage joint, tendonitis, and other musculoskeletal pain. At Kai Sports Medicine, Zachary Perlman, DO, performs joint injections in Oakhurst to offer patients relief from pain.

Joint injection techniques vary depending on the joint.

1.      Shoulder joint

Chronic shoulder pain can last longer than six months. Your care provider will consider joint injections after conservative interventions like if physical therapy has failed to offer pain relief.

2.      Glenohumeral joint

This ball-and-socket synovial joint is relatively unstable and prone to injury because the humeral head is large. Only part of it can articulate with the glenoid fossa at different joint positions. Medical conditions such as arthritis can cause instability in the joint, resulting in limited shoulder movement.

An anterior or posterior technical approach is applied when injecting the glenohumeral joint. Your doctor may perform the injection blind or with ultrasound guidance.

For easy joint access during blind injections, you will sit comfortably with your arm at the side palm facing out or forward. This position favors the anterior approach. For the posterior approach, you should internally rotate your shoulder by placing your forearm across your body.

3.      Acromioclavicular joint

·         Blind Approach: Patients are usually seated with the affected arm relaxed on the side. Your doctor will palpate the clavicle distally to locate the acromioclavicular joint. A superior and anterior needle insertion approach is used.

·         Fluoroscopic Approach: You will be in the supine position with the image intensifier anteroposteriorly located.

·         Ultrasound Approach: The transducer will be vertical and superior to the acromioclavicular joint area. Your doctor will continuously adjust the transducer to detect joint space and use an in-plane technique to advance the needle into space.

4.      Hip injections

a)  Intra-articular hip injections

·         Fluoroscopic Anterior Approach: Your doctor will advance the needle toward the femoral head and neck junction.

·         Ultrasound Approach: Your doctor will adjust the transducer to visualize femoral structures and advance a 22-gauge spinal needle into the femoral head and neck junction.

b)  Trochanteric bursa injections

·         Blind Approach: From the lateral decubitus position, your doctor will identify the greater trochanter and insert a spinal needle perpendicular to the skin at the site of tenderness.

·         Fluoroscopic Approach: As you lie in the lateral position, your doctor will then identify the bursa using fluoroscopy and advance a spinal needle into the bursa.

·         Ultrasound Approach: Your doctor will use a transducer to locate the bursa and perform the injection under real-time sonography employing the lateral approach.

5.      Knee joint

·         Midpatellar Approach: The patient is usually in the supine position. Your doctor will insert the needle between the patella and femur.

·         Anterior Approach (Infrapatellar): Your doctor will advance the needle into the inferior patellar tendon, medially or laterally.

·         Fluoroscopic Approach: Care providers use fluoroscopic guidance for obese patients to access the intra-articular space.

·         Ultrasound Suprapatellar Approach: The patient is usually in the supine position. Your doctor will use a transducer to locate the tender area and advance the needle into it.

 Contact Kai Sports Medicine LLC to learn more about joint injections by booking your appointment online today.