Majdalani Carl, Boudier-Revéret Mathieu, Pape John, Brismée Jean-Michel, Michaud Johan, Luong Dien Hung, Grabs Detlev, Chang Ke-Vin, Chen Wen-Shiang, Wu Chueh Hung, Sobczak Stéphane
Department of Physical Medicine and Rehabilitation, Centre hospitalier de l'Université de Montréal, Montréal, Canada.
Department of Physiotherapy, University Hospital of North Tees, Stockton on Tees, United Kingdom.
PM R. 2019 Sep;11(9):989-995. doi: 10.1002/pmrj.12079. Epub 2019 Apr 1.
Glenohumeral idiopathic adhesive capsulitis is a common shoulder condition that hinders functionality. Addressing the pathology has been extensively researched. Ultrasound (US)-guided injections have shown their efficacy. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the coracohumeral ligament (CHL).
To investigate whether US-guided injection of the CHL can be performed accurately using either the rotator interval (RI) or the coracoidal (CO) approach.
An experimental cadaveric case series.
Anatomy laboratory.
Both shoulders of 13 Thiel-embalmed cadavers.
Three physiatrists each injected a 0.1 mL bolus of colored dye in both shoulders of each cadaver using either the RI or the CO approach under US guidance. Each cadaver received a total of six injections (three injections per shoulder). The accuracy of the injection was determined following shoulder dissection by an anatomist.
The accuracy of the US-guided injection of the CHL.
The RI approach yielded 36 accurate injections, giving it an accuracy of 100%. With the CO approach two injections were deemed inaccurate yielding an accuracy of 94%. There was no significant difference in accuracy between all operators.
US-guided injection of the CHL can be performed accurately with both the RI and CO approaches. The RI approach was likely to be more accurate.
肩关节特发性粘连性关节囊炎是一种常见的肩部疾病，会妨碍肩部功能。针对其病理机制已进行了广泛研究。超声（US）引导下的注射已显示出其有效性。然而，尚未有研究比较不同方法在靶向喙肱韧带（CHL）时的解剖学准确性。
研究在超声引导下，使用旋转间隙（RI）或喙突（CO）入路能否准确地对CHL进行注射。
一项实验性尸体病例系列研究。
解剖实验室。
13具经蒂尔氏防腐处理尸体的双侧肩部。
三名物理治疗师在超声引导下，分别使用RI或CO入路，在每具尸体的双侧肩部各注射0.1 mL含色染料团注。每具尸体共接受六次注射（每侧肩部三次）。注射准确性由一名解剖学家在肩部解剖后确定。
超声引导下CHL注射的准确性。
RI入路有36次准确注射，准确率为100%。CO入路有两次注射被认为不准确，准确率为94%。所有操作者之间的准确性无显著差异。
超声引导下使用RI和CO入路均可准确地对CHL进行注射。RI入路可能更准确。
