Glenohumeral Joint Injection

     The glenohumeral joint is where the humerus articulates with the glenoid fossa. It is the most mobile joint in the body. It affects a very large patient population, from young athletes engaged in overhead activities to elderly patients with diabetes.

        Patients who complain of glenohumeral pain usually describe the anterior and posterior of the shoulder joint. Patients with adhesive capsulitis and glenohumeral arthrosis experience pain throughout the full range of motion of the joint. Joint movement limitation, primarily external rotation, may be observed.

     The joint is stabilized by soft tissue configurations of some ligaments and muscles, including the four muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis) that serve as dynamic stabilizers of the joint. Static stabilizers include the joint capsule, glenoid labrum, and glenohumeral ligaments

                               Indications and diagnosis

      There are three main indications for glenohumeral joint injection: osteoarthritis, adhesive capsulitis (frozen shoulder), and rheumatoid arthritis.

      Osteoarthritis of the shoulder typically occurs in older people or younger people following traumatic injury. Patients usually present with chronic pain, decreased range of motion, and accompanying fatigue.

      Adhesive capsulitis (frozen shoulder) is a condition typically seen in middle-aged and older adults and is usually associated with a traumatic injury or use of the shoulder secondary to pain, discomfort, or prolonged immobilization. The condition is more common in women and people with diabetes. Often there is accompanying tendinosis or bursitis.

     Rheumatoid arthritis is an autoimmune systemic inflammatory disease involving inflammation of the synovium of the shoulder joint.

     In glenohumeral joint pathology, a physical examination may find a painful and decreased range of motion, decreased muscle strength, and palpable crepitus with shoulder movement.

                                          technique

       Glenohumeral injection administration; USG can be applied with fluoroscopy or directly. The application is carried out with the patient in a sitting position, 1 cm below and 1 cm medial to the acromial after proper disinfection conditions are met. The tip of the needle should be in the direction of the coracoid process. Before the drug is given, it should be seen that there is no vascular structure by aspiration, and the plunger of the injector should be pushed slowly. It is a 10-minute daily procedure. The patient is sent home after 10 minutes.