Most shoulders are examined with the patient seated
There is no need to change position prior to injection.
The needle is targeted on the rounded poorly reflective joint space.
The AC joint is easily identified in the coronal plane.
If there is any subluxation present, the lateral aspect of the joint is open to an approach from the lateral side.
If there is no malalignment or effusion, the joint is best injected in the sagittal plane.
Place the probe medial to the joint and identifying the clavicle.
The probe is then moved laterally until the bony reflection disappears indicating that the probe is now positioned directly over the joint
Further lateral movement brings the bony acromium into view.
The probe is returned to overlie the joint either anteriorly or posteriorly and the needle is inserted at 90 degrees to it in the sagittal plane.
