Editorial Commentary: Unguided Glenohumeral Injections-Do We Achieve Sufficient Accuracy?

Image-guided (fluoroscopy, ultrasound, computed tomography, magnetic resonance imaging) and unguided glenohumeral injection techniques are frequently used for different diagnostic and therapeutic purposes in clinical practice. Guided injections are highly accurate, reproducible, and more often performed in routine practice. Nevertheless, these techniques are more cost intensive and time consuming, and require special imaging devices. In case of fluoroscopic- or computed tomography-guided injections, radiation exposure of the patient is a disadvantage. In contrast, unguided glenohumeral injection techniques do not have these drawbacks, but rather are based on the precise identification of anatomic landmarks and depend on the experience of the provider. That is the reason they are supposed to be less accurate and less reproducible than guided techniques. But recent studies showed comparable accuracy; therefore, the use of unguided glenohumeral injection techniques should be considered in daily clinical practice in the hands of experienced shoulder arthroscopists.