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The subacromial bursa can be injected using anterior, lateral, or posterior approaches. To determine which approach is best, U.S. researchers performed a study in which each of 75 patients with rotator cuff syndrome was randomized to one of these three approaches. A single orthopedist (who traditionally had used the posterior approach) performed all injections, which contained corticosteroid, local anesthetic, and radiopaque contrast medium. After the injections, shoulders were x-rayed to determine whether the contrast was within the bursa.
The proportion of patients whose injections were intrabursal was significantly greater with the lateral and anterior approaches (92% and 84%, respectively) than with the posterior approach (56%). The lowe…