Shoulder injection site steroids

Hey There! I’m from Australia and had a MRI with dye yesterday! 🙂 I just want everyone to know it didn’t hurt much AT ALL!! I have had a crook shoulder for 3 years which I injured while swimming in a deep river with a massive current. I got a cramp in my shoulder while I was swimming a long way from shore and I HAD to keep swimming else I’d end up at sea! 🙂 I was in SO much pain that night – suffering from impingement. It SUXED!!!!! (Need I add, this was on my birthday too! 🙁 ) Anyway, I’ve had physio, a cortisone shot (that helped TEMPORARILY til I re-injured the blasted thing!! as I am super active! 🙂 ) had an Ultra sound – and no tears showed up. So I went to a BRILLIANT Ortheopaedic specialist and he required a MRI with dye.

1) Shoulder replacements - When arthritis pain becomes debilitating, shoulder replacement and resurfacing are permanent treatments. Shoulder resurfacing is a bone preserving alternative. I was the first surgeon to do Shoulder resurfacing in Chennai. See here . I have performed the first combined metal and  stem cell biological resurfacing   in the world.  
A reverse shoulder replacement is a very useful procedure in cases of bone and soft tissue loss. I am one of the few surgeons to have done this procedure in India. I got trained in these advanced procedures in the UK and Belgium.
2) Arthroscopic stabilization for instability- I perform  arthroscopic  &  open Bankart repair  for recurrent shoulder dislocation.
3)  Rotator cuff repair-  Arthroscopic assisted mini open repair is effective in relieving pain. I also offer stem cell treatment to repair partial and complete tears.
4) Stem cell treatment of partial and complete rotator cuff tears and other shoulder conditions.
5) Arthroscopic repair  for SLAP lesions.
6) Resistant cases of frozen shoulder are advised  arthroscopic release  or manipulation under anesthesia (MUA). Arthroscopic release is performed for those cases which don’t yield to the above measures.
7) In severe fractures,  replacement  a hemi-arthroplasty or a reverse shoulder replacement) may be needed.

In the past 6 months my right knee is giving me fits. The pain in on the inside of the joint and begins to hurt after only a small amount of walking. It also appears that walking downhill is worse than up. I have used ointments and heating wraps and leg supports and all work a little but just temporary. I do have some stiffness in the morning and on and off during the day. I am 75 years old and somewhat over weight. I came to you about a year ago with my right hip giving me trouble. I stopped jogging and went to walking as an exercise. The hip stopped hurting but now transferred to my knee. I did physical therapy on my hip which helped my range of movement as there was a remarkable difference in the range of my right to my left. Would the 6 month shot stop this pain or do I need a knee replacement?

Procedure
This should be preformed under ultrasound guidance, as the biceps tendon is deep under the thick deltoid and impossible to 'feel' with the needle. Injecting the biceps tendon with a proteolytic steroid can also increase the risk of tendon rupture. Therefore, we prefer to use a hyaluronan (Ostenil) in young patients.
The patient sits with their arm resting by their side. Due to the great variation in humeral version, the tendon position can only be judged by rotating the arm into the best position for injection and letting the patient rest it their. The LHB tendon and groove are identified and marked on the skin with a marker. The point of injection, just lateral to the ultrasound probe is marked. The needle is directed at a 45 degree angle in the long axis of the probe, heading towards the LHB sheath and tendon. The actual tendon is not injected but rather the swollen sheath around the tendon. The injected fluid can be seen to run into the sheath.

Shoulder injection site steroids

shoulder injection site steroids

Procedure
This should be preformed under ultrasound guidance, as the biceps tendon is deep under the thick deltoid and impossible to 'feel' with the needle. Injecting the biceps tendon with a proteolytic steroid can also increase the risk of tendon rupture. Therefore, we prefer to use a hyaluronan (Ostenil) in young patients.
The patient sits with their arm resting by their side. Due to the great variation in humeral version, the tendon position can only be judged by rotating the arm into the best position for injection and letting the patient rest it their. The LHB tendon and groove are identified and marked on the skin with a marker. The point of injection, just lateral to the ultrasound probe is marked. The needle is directed at a 45 degree angle in the long axis of the probe, heading towards the LHB sheath and tendon. The actual tendon is not injected but rather the swollen sheath around the tendon. The injected fluid can be seen to run into the sheath.

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