Ultrasound-Guided Intra-Articular Injection

Intra-articular shoulder injection and nerve block procedures are generally applied in cases that develop due to shoulder pathologies such as adhesive capsulitis, i.e. frozen shoulder. In this disease, shoulder movements are restricted in all directions. While the cause of the disease is sometimes undetermined, in some cases risk factors such as chronic lung disease, pulmonary tuberculosis, coronary artery disease, diabetes mellitus, cervical syndromes and Dupuytren's contracture may cause immobilization of the shoulder.

The injection procedures we perform under ultrasonography guidance aim to relieve patients' pain and loss of function. Before the procedure, the patient is informed about possible side effects and complications and his/her consent is obtained. If the patient uses blood thinners, the medication should be discontinued and the procedure should be performed later.

Intra-articular shoulder injection and nerve block procedures are generally applied in cases that develop due to shoulder pathologies such as adhesive capsulitis, i.e. frozen shoulder. In this disease, shoulder movements are restricted in all directions. While the cause of the disease is sometimes undetermined, in some cases risk factors such as chronic lung disease, pulmonary tuberculosis, coronary artery disease, diabetes mellitus, cervical syndromes and Dupuytren's contracture may cause immobilization of the shoulder.

The injection procedures we perform under ultrasonography guidance aim to relieve patients' pain and loss of function. Before the procedure, the patient is informed about possible side effects and complications and his/her consent is obtained. If the patient uses blood thinners, the medication should be discontinued and the procedure should be performed later.

After the estimated injection site for intra-articular injection and nerve blockade procedures is determined and marked, the area is disinfected and anesthetized with local anesthetic needles. In this way, pain during injection is minimized. As needles, we use 26 gauge thick and 9 cm long spinal needles. It is important that the needle is thicker than other needles so that its progress can be observed with the ultrasonography probe and the success of the injection. *Studies have shown that intra-articular injection under ultrasonography guidance has an accuracy rate of up to 95%. * After waiting for the effect of the anesthetic agent, we first complete the shoulder joint and then nerve blockage procedures.

Our injection materials contain low doses of cortisone, commonly known as steroid, local anesthetic and some saline.

After the injection, we monitor the patients for 30 minutes for late anaphylactic reactions, which are rarely seen due to local anesthetics. In addition, patients are informed that conditions such as steroid-induced high blood sugar, skin changes and septic arthritis may rarely occur. Patients should be monitored in the days after the procedure and a diet low in carbohydrates and salt is recommended in the first week. Patients are informed that it is recommended to remove the dressing and take a bath in the procedure area after the injection.

As a result, these procedures enable patients to feel less pain during physical therapy, especially during stretching exercises, and to eliminate loss of movement more easily. The effect duration of the procedure is expected to be at least 2-3 months.