724 Fig. 1 Schematic drawing of the anterior view of the right shoulder showing the puncture sites of the fluoroscopic- (X) and US-guided (●) anterior injection techniques shoulder was draped in sterile fashion. The needle is inserted at the level of the coracoid, from lateral to medial, aimed at the medial border of the humeral head (Figs. 1 and 5) [3]. The contrast medium can be seen flowing in the direction of the subscapular recess and joint space. The USp approach, described by Cicak [2] and modified by Zwar [14], was performed using a APLIO US machine (Toshiba Medical Systems Corporation, Tokyo, Japan) with a 7.5–14-MHz linear array transducer (Toshiba PLF- Fig. 3 Fluoroscopic-guided anterior approach. X-ray of the anterior view of a right-hand shoulder showing the needle entry site. The needle is inserted vertically at the inferomedial quadrant of the humeral head. The intra-articular position of the needle tip is confirmed by injecting a little iodinated contrast media, which demarcates the hyaline cartilage (black arrows) of the humeral head 805ST). The patient is either lying obliquely prone on the contralateral shoulder or sitting upright with the back to the radiologist and the ipsilateral hand on the contralateral shoulder. After skin and transducer preparation with alcohol 70%, the patient’s shoulder was draped in sterile fashion. The needle is inserted, from lateral to medial, parallel to the long axis of the transducer and advanced under US control in the joint between the humeral head and the posterior glenoid labrum (Figs. 2 and 6) [14]. Fig. 2 Schematic drawing of the posterior view of the right shoulder showing the puncture sites of the fluoroscopic- (X) and US-guided (●) posterior injection techniques Fig. 4 Fluoroscopic-guided posterior approach. X-ray of the posterior view of a right-hand shoulder showing the needle entry site. The needle is inserted vertically at the inferomedial quadrant of the humeral head. The intra-articular position of the needle tip is confirmed by injecting a little iodinated contrast media, which demarcates the hyaline cartilage (black arrow) of the humeral head