Transcoracoacromial Ligament Glenohumeral Injection Technique Using Bony Surface Landmarks

Intra-articular glenohumeral injection is an important technique used to diagnose and treat shoulder disorders. However, it is frequently performed as an image-guided technique with the use of fluoroscopy, ultrasound, computed tomography, or magnetic resonance. The purpose of this Technical Note is to describe a transcoracoacromial ligament glenohumeral injection technique that uses anatomic surface landmarks to avoid the need for radiographic guidance. After identification of the anterolateral corner of acromion, the superior lateral border of the coracoid tip, and the curved depression of the distal clavicle, the needle entry site is determined at the trisection point between the distal and middle thirds of the line formed by the superior lateral border of the coracoid tip and the curved depression of the distal clavicle. The needle is first inserted perpendicular to the triangular plane of the 3 points and is then advanced toward the humeral head. This injection technique is highly accurate and reproducible and can be done in the outpatient clinic without the use of imaging guidance, reducing the costs and barriers of intra-articular glenohumeral injections for patients.