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. 2019 Sep;11(9):989-995.
doi: 10.1002/pmrj.12079. Epub 2019 Apr 1.

Accuracy of Two Ultrasound-Guided Coracohumeral Ligament Injection Approaches: A Cadaveric Study

Carl Majdalani  1 , Mathieu Boudier-Revéret  1 , John Pape  2 , Jean-Michel Brismée  3 , Johan Michaud  1 , Dien Hung Luong  1 , Detlev Grabs  4   5 , Ke-Vin Chang  6 , Wen-Shiang Chen  6 , Chueh Hung Wu  6 , Stéphane Sobczak  4   5
Affiliations

Accuracy of Two Ultrasound-Guided Coracohumeral Ligament Injection Approaches: A Cadaveric Study

Carl Majdalani et al. PM R. 2019 Sep.

Abstract

Background: Glenohumeral idiopathic adhesive capsulitis is a common shoulder condition that hinders functionality. Addressing the pathology has been extensively researched. Ultrasound (US)-guided injections have shown their efficacy. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the coracohumeral ligament (CHL).

Objective: To investigate whether US-guided injection of the CHL can be performed accurately using either the rotator interval (RI) or the coracoidal (CO) approach.

Methods: An experimental cadaveric case series.

Setting: Anatomy laboratory.

Specimens: Both shoulders of 13 Thiel-embalmed cadavers.

Interventions: Three physiatrists each injected a 0.1 mL bolus of colored dye in both shoulders of each cadaver using either the RI or the CO approach under US guidance. Each cadaver received a total of six injections (three injections per shoulder). The accuracy of the injection was determined following shoulder dissection by an anatomist.

Main outcome measure: The accuracy of the US-guided injection of the CHL.

Results: The RI approach yielded 36 accurate injections, giving it an accuracy of 100%. With the CO approach two injections were deemed inaccurate yielding an accuracy of 94%. There was no significant difference in accuracy between all operators.

Conclusions: US-guided injection of the CHL can be performed accurately with both the RI and CO approaches. The RI approach was likely to be more accurate.

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