Fluoroscopically guided supraglenoid tubercle steroid injections for the management of biceps tendonitis

The management of bicipital tendonitis can be challenging to the clinician. Traditionally, blind injections near the bicipital groove have been performed by clinicians with risk of bicipital tendon rupture or atrophy. Because of the inaccuracy and risk associated with blind bicipital tendon steroid injections, we sought to ascertain whether a fluoroscopically guided steroid injection into the region of the origin of the long head of the bicipital tendon (supraglenoid tubercle) was efficacious.

A retrospective chart review of 6 consecutive patients with a diagnosis of bicipital tendonitis was performed. All patients underwent a fluoroscopically guided steroid/anesthetic injection into the supraglenoid tubercle of the shoulder. The main outcome measure was post-procedure change in visual analog pain scale; the secondary outcome was the physical examination (presence of a Speed's test).

Ten cases were identified, but only 6 had complete data and were included in the analysis. Five of the 6 patients experienced a reduction in pain by 50% at follow-up.

A fluoroscopically guided block injected into the supraglenoid tubercle may be effective in the management of bicipital tendonitis.