ABSTRACT

Intra-articular injections are one of the commonly used treatment modalities for acute injuries or pain relief in chronic conditions of the musculoskeletal system. The aim of this study was to evaluate the accuracy rate of acromioclavicular (AC) joint injections made with palpation and contrast agent by fluoroscopy.

This cadaver study was carried out with the approval of Istanbul Forensic Medicine Institution Ethics Committee. Human cadavers were assessed by preinjection fluoroscopy at Istanbul Forensic Medicine Institute and forty-two AC joints of 21 cadavers without arthrosis were included in the study. All of the injections were made by palpation technique by an experienced orthopedist in the shoulder area. The accuracy of injections was assessed with fluoroscopic images obtained from both planes.

A total of 42 AC joint injections with contrast material of 11 male and 10 female patients with a mean age of 41 (range: 29-48 years) on both shoulders were included in the study. Only 17 injections were within the AC joint confirmed by fluoroscopy (10 right, 7 left, accuracy: 40.4%). There was no significant difference in the mean age (41 and 42 years, p=0.58), male / female ratio (p=0.73) and injection site between correct and incorrect injections.

The accuracy rate of palpation-guided AC joint injection was found to be low even in the absence of joint pathology. In clinical practice, performing AC joint injection together with an imaging modality may help to increase the accuracy of the injection.