This is the first in a series of papers on procedure-oriented joint anatomy. This paper will review anatomy of the shoulder joint and focus on non-imaging-guided procedures. Needle procedures of the shoulder include glenohumeral, subacromial, and acromioclavicular joint injections; electromyography; trigger point and other intramuscular injections; bicipital tendon sheath injection; suprascapular nerve blocks; and botulinum toxin injections. The accuracy of these non-imaging-guided procedures is reviewed. Complications of these procedures include infection, damage to tendon, and local or systemic response to medication. This paper provides anatomically accurate schematics of the shoulder anatomy relevant to needle procedures. Cross-sectional schematics of the shoulder were drawn as they appear on axial and sagittal projections. Superficial and deep landmarks are highlighted and sources of potential complications. The schematics allow for safer and more accurate non-image-guided needle procedures in the shoulder region.
From the *Department of Physical Medicine and Rehabilitation, Baylor College of Medicine; †Center for Trauma Rehabilitation Research, Quentin Mease Hospital, Harris County Hospital District; ‡Department of Neurobiology and Anatomy, University of Texas School of Medicine; §Department of Neurology, Baylor College of Medicine, Houston, TX; ∥Mid-Atlantic Mental Illness Research, Education, and Clinical Center, VISN 6, Durham, NC; and ¶Research and Education Service Line, W. G. Hefner Veterans Affairs Medical Center, Salisbury, NC.
Received for publication June 8, 2009; accepted June 9, 2009.
Reprints: John S. Harrell, MD, Department of Physical Medicine and Rehabilitation, Quentin Mease Hospital, Suite No. 240, 3601 N MacGregor, Houston, TX 77004 (e-mail: email@example.com).