In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Injection of the subacromial bursa in patients with rotator cuff syndrome: a prospective, randomized study comparing the effectiveness of different routes.
BACKGROUND Rotator cuff syndrome is often treated with subacromial injection of corticosteroid and local anesthetic . It has not been established if the common injection routes of the bursa are equally accurate . METHODS We conducted a prospect i ve clinical trial involving seventy-five shoulders in seventy-five patients who were r and omly assigned to receive a subacromial injection through an anterior , lateral , or posterior route with respect to the acromion . An experienced physician performed the injections , which contained radiopaque contrast medium , corticosteroid , and local anesthetic . After the injection , a musculoskeletal radiologist , blinded to the injection route , interpreted all of the radiographs . RESULTS The rate of accuracy varied with the route of injection , with a rate of 56 % for the posterior route , 84 % for the anterior route , and 92 % for the lateral route ( p = 0.006 ; chi-square test ) . The accuracy of injection through the posterior route was significantly lower than that through either the anterior or the lateral route ( p < 0.05 for both comparisons ; Poisson regression ) . In addition , the accuracy of injection was significantly lower in females than in males ( p < 0.006 ; chi-square test ) . Among males , no differences between the routes were noted ( with accuracy rates of 89 % for the posterior route , 92 % for the anterior route , and 93 % for the lateral route ) . Among females , however , the accuracy of injection was lower for the posterior route than for either the anterior or the lateral route ( with accuracy rates of 38 % for the posterior route , 77 % for the anterior route , and 91 % for the lateral route ) ( p < 0.05 ) . CONCLUSIONS The anterior and lateral routes of subacromial bursal injection were more accurate than the posterior route . The accuracy of subacromial bursal injection was significantly different between males and females , mainly because of a lower accuracy of bursal injection with use of the posterior route in females . The present study suggests that the posterior route is the least accurate method for injection of the subacromial bursa in females
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .