COMPARISON OF THE ACCURACY OF STEROID PLACEMENT WITH CLINICAL OUTCOMEIN PATIENTS WITH SHOULDER SYMPTOMS

Objective-To study the effect of accuracy on the clinical outcome of l ocal steroid injections to the shoulder. Methods-37 patients with shou lder symptoms of at least two months' duration received local injectio ns of a mixture of triamcinolone and radiographic contrast material us ing a standardised technique. Radiographs of the joint were taken imme diately afterwards. Details of the patients' symptoms (assessed by vis ual analogue scales) and range of movement at the joint were obtained before and two weeks after the injection. At follow up the patients we re also assessed by means of a five point global rating scale of maxim um and current benefit. Results-14 of the 38 procedures (37%) were jud ged to be accurately placed: four of the 14 attempted subacromial inje ctions (29%) and 10 of the 24 attempted glenohumeral injections (42%). There were significant differences in relation to outcome between the accurately placed and the inaccurately placed groups. Conclusions-Acc uracy of steroid placement by injection in patients with shoulder symp toms may significantly affect the clinical outcome.