Shoulder Joint Block and Pumping (X-Ray-Guided)

Abstract

Shoulder joint pumping is a procedure to repeat irrigation/aspiration by injecting contrast agent, local anesthetic, and saline into the joint. The response mechanism is considered adhesiolysis, decrease of articular internal pressure, washing/stimulation to the membrane, stretching wrinkles on the joint capsule, and spreading infusion to every corner of the joint. A patient should be in the supine position on the X-ray fluoroscopic stand. Under clavicle shadow, the puncture site should be determined by hitting forceps onto the site where the shadow of the acetabular and the epiphysis crosses. Feeling resistance from the subscapularis muscle tendon and the joint capsule, keep advancing a nerve block needle until it enters the shoulder joint capsule (glenohumeral joint). After the arthrography for the shoulder joint block, inject drug solution (hyaluronic acid or lidocaine), and complete this procedure. For shoulder joint pumping, repeat infusion and wasting of saline (or 0.5% lidocaine) 3–5 times.