Accuracy of the glenohumeral injection using the superior approach: a cadaveric study of injection accuracy

Am J Phys Med Rehabil. 2010 Sep;89(9):755-8. doi: 10.1097/PHM.0b013e3181e7201a.


Objective: The glenohumeral joint can be accessed by anterior, posterior, or superior approach. Blind shoulder injections using anterior or posterior approach have been often inaccurate and infiltrated untargeted structures. The aim of this study was to investigate the success rate of injections in the glenohumeral joint using the superior approach.

Design: Nineteen shoulders from 12 adult cadavers were anatomically dissected after a dye injection had been performed, with cadavers in the supine position. A clinician rated injection confidence scores. The dissectors rated injection accuracy scores and investigated untargeted structures penetrated.

Results: The clinician's confidence scores were the highest in 18 of 19 shoulders. Superior glenohumeral injections were successful in 18 of 19 (94.7%) shoulders; however, in 3 of these 18 shoulders, the long heads of biceps tendons were penetrated.

Conclusions: The glenohumeral joint injection using the superior approach is accurate and clinically useful, but caution for the likelihood of penetrating the long head of biceps tendon should be considered.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cadaver
  • Clinical Competence*
  • Female
  • Humans
  • Injections, Intra-Articular / methods*
  • Male
  • Middle Aged
  • Patient Positioning*
  • Self Efficacy
  • Shoulder Joint*