Comparing Two Methods of Subacromial Space Injection

Study Overview
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Brief Summary
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Subacromial shoulder injections can be approached from the front or side of the shoulder. The investigators are comparing both methods, to find which one has better spread in the subacromial space.

Detailed Description
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Both lateral and posterio-lateral methods of subacromial injections are widely used for diagnostic and therapeutic purposes. It is not known which method allows the most accurate access into the subacromial space and is more effective. The investigators have been using a novel approach from the anterior aspect of the shoulder for years with good clinical effect and propose comparing this approach to the described approach. This study will indicate which method is best and will be of practical clinical importance. The investigators feel the technique is easier to perform than other described methods and could be taught to clinicians throughout the country and adopted as the standard approach.

Official Title
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Comparing Two Methods of Subacromial Space Injection - A Randomised Blinded Trial

Conditions
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Subacromial Impingement Syndrome

Intervention / Treatment
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* Procedure: Subacromial Injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Shoulder pain for at least 6 weeks duration along the lateral aspect of the shoulder. Positive impingement signs. Exclusion Criteria: History of compensation claim due to shoulder problems. Allergy to radiographic dye. Recent shoulder fracture. Bleeding disorder. Previous shoulder surgery.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Anterior portal<br>Injection in to subacromial space from anterior portal | Procedure: Subacromial Injection<br>* Injection in to subacromial space in the shoulder from anterior portal<br>|
| Active Comparator: Lateral portal<br>Injection in to subacromial space from lateral portal | Procedure: Subacromial Injection<br>* Injection in to subacromial space in the shoulder from anterior portal<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The spread of dye in subacromial space | The participants will go for an X ray following injection which contains a radio-opaque dye to demonstrate the spread of injected material (Local anaesthetic, depomedrone and Niopam dye) in the subacromial space. A blinded radiologist will read the radiographs and scale the distribution of dye from 1 to 4 depending on the location of radiopaque dye. | With in One hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain control after subacromial injection | The participants will fill a visual analog score before and after injection to assess the pain relief after injection. | With in One hour |