Kozlowski Benjamin J, Tran John, Peng Philip W H, Agur Anne M R, Mittal Nimish
Temerty Faculty of Medicine, Division of Anatomy, Department of Surgery, 1 Kings College Circle, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.
Department of Anesthesiology and Pain Management, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T2S8, Canada.
Interv Pain Med. 2022 Nov 30;1(4):100164. doi: 10.1016/j.inpm.2022.100164. eCollection 2022 Dec.
Rotator interval (RI) corticosteroid injections are used to alleviate pain associated with adhesive capsulitis, though the pattern of injectate spread remains unclear. The purpose of this anatomical study was to assess the staining patterns of intra-articular, intracapsular/extrasynovial, and pericapsular structures of the glenohumeral joint following medial-to-lateral and lateral-to-medial RI injections.
Ten cadaveric specimens were injected with a methylene blue dye injectate: five using a medial-to-lateral RI injection technique and five using a lateral-to-medial RI injection technique. Serial dissection was performed to assess the staining of intra-articular, intracapsular/extrasynovial, and pericapsular structures. The frequency of capture and degree of staining were compared between injection groups.
The lateral-to-medial injection resulted in the capture of all intra-articular; intracapsular/extrasynovial; and pericapsular structures, whereas the medial-to-lateral injection did not consistently stain all structures. Intracapsular/extrasynovial structures (superior glenohumeral ligament and the long head of biceps tendon) were more darkly stained in the lateral-to-medial group, and pericapsular structures (supraspinatus tendon and coracohumeral ligament) were more darkly stained in the medial-to-lateral group.
The frequency of capture and degree of staining of intra-articular, intracapsular/extrasynovial, and pericapsular structures of the glenohumeral joint differed between medial-to-lateral and lateral-to-medial RI injection techniques, which may influence outcomes in pain management for adhesive capsulitis.
尽管肩袖间隙（RI）皮质类固醇注射剂用于减轻与粘连性关节囊炎相关的疼痛，但其注射剂扩散模式仍不清楚。本解剖学研究的目的是评估经内侧至外侧和外侧至内侧RI注射后，盂肱关节的关节内、囊内/滑膜外和关节周围结构的染色模式。
向10个尸体标本注射亚甲蓝染料注射剂：5个采用内侧至外侧RI注射技术，5个采用外侧至内侧RI注射技术。进行连续解剖以评估关节内、囊内/滑膜外和关节周围结构的染色情况。比较注射组之间的捕获频率和染色程度。
外侧至内侧注射导致所有关节内、囊内/滑膜外和关节周围结构均被染色，而内侧至外侧注射并未始终使所有结构染色。外侧至内侧组中，囊内/滑膜外结构（肩胛上盂肱韧带和肱二头肌长头肌腱）染色更深，内侧至外侧组中，关节周围结构（冈上肌腱和喙肱韧带）染色更深。
内侧至外侧和外侧至内侧RI注射技术在盂肱关节的关节内、囊内/滑膜外和关节周围结构的捕获频率和染色程度上存在差异，这可能会影响粘连性关节囊炎疼痛管理的效果。
