The Pain Source

By Chris Faubel, M.D. –

One video below.  Click the black title link above (if you can’t see the video).

1)   Right subacromial bursa injection under fluoroscopy.

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• VIDEOS: Miscellaneous
• VIDEO: Glenohumeral Shoulder Intraarticular Steroid Injection Under Fluoroscopy
• Acromioclavicular Joint Injection – Technique and Tips
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• VIDEOS: Lumbar Facet Injections under Fluoroscopy

aka. “Hawkins-Kennedy test”

Hawkins Impingement Test

Patient Position

• Seated

Procedure Steps

• Examiner stands in front of, or to the side of the patient.
• Involved shoulder is forward flexed to 90°, and the elbow is flexed to 90°
• Examiner supports the forward flexed arm with one hand, while internally rotating the shoulder (humerus).

Positive sign / Significance

• Shoulder pain = Supraspinatus tendinitis/impingement

Related Content:

• VIDEO: Subacromial Bursa Injection under fluoroscopy
• Neer’s Impingement Test
• Pes Anserine Bursa Injection – Technique and Tips
• Acromioclavicular Joint Injection – Technique and Tips
• Subacromial Bursa Injection – Technique and Tips

Patient Position

• Seated

Procedure Steps

• Involved shoulder is slightly abducted.
• Forward flexion (passively) of the arm in the scapular plane, until the upper arm is close to the ear.

Positive sign / Significance

• Shoulder pain = Supraspinatus tendinitis/impingement

Comments

• Procedure causes an impingement of the supraspinatus tendon between the humeral head and the anteroinferior acromion process.
• May also be positive with bicipital tendonitis (long head).

Related Content:

• Hawkins Impingement Test
• VIDEO: Subacromial Bursa Injection under fluoroscopy
• Empty Can Test
• Ultrasound – Shoulder Exam Setup
• VIDEO: Glenohumeral Shoulder Intraarticular Steroid Injection Under Fluoroscopy

Related Content:

• Ultrasound – Acromioclavicular Joint Exam
• Ultrasound – Hip Joint
• Ultrasound – Tibiotalar Joint Injection and Aspiration
• Ultrasound – Supraspinatus Tendon Exam
• Ultrasound – Infraspinatus Tendon Exam

By Chris Faubel, MD –

Two videos below. Click the black title link above (if you can’t see the video).

1. Left glenohumeral injection using an approach to avoid the articular cartilage, but still get under the rather large joint capsule.
2. Left glenohumeral injection using an approach to enter the actual joint - Special thanks to Dr. Hazem Eissa for providing this second fluoroscopic video clip.

Related Content:

• VIDEO: Subacromial Bursa Injection under fluoroscopy
• VIDEO: Hip Intraarticular Steroid Injection Under Fluoroscopy
• Intraarticular Knee Joint Injection – Technique and Tips
• Acromioclavicular Joint Injection – Technique and Tips
• Subacromial Bursa Injection – Technique and Tips

By Chris Faubel, MD –

Acromioclavicular Joint Corticosteroid Injection

Indications

• Acromioclavicular joint osteoarthritis
• Acromioclavicular joint sprain
• Acromioclavicular joint separation
• **see all ICD-9 and ICD-10 codes at end of post
  

CPT code: 20605

Materials Needed

• Read the full story

Related Content:

• Intraarticular Knee Joint Injection – Technique and Tips
• Subacromial Bursa Injection – Technique and Tips
• Pes Anserine Bursa Injection – Technique and Tips
• Plantar Fascia Injection – Technique and Tips
• Medial Epicondyle Injection – Technique and Tips

Subacromial Bursa Injection - Lateral Approach

By Chris Faubel, MD –

Indications

• Subacromial bursitis
• Rotator cuff tear, degenerative, tenosynovitis
• Shoulder impingement
• **see all ICD-9 and ICD-10 codes at the end of the post

CPT code: 20610

Materials Needed

• Read the full story

Related Content:

• Pes Anserine Bursa Injection – Technique and Tips
• Intraarticular Knee Joint Injection – Technique and Tips
• Acromioclavicular Joint Injection – Technique and Tips
• Olecranon Bursa Aspiration and Injection – Technique and Tips
• Prepatellar Bursa Aspiration and Injection – Technique and Tips