The Shoulder

Infiltrations

Indications

Diagnostic, as confirmation of a tentative diagnosis
Supraspinatus tendinitis at the musculotendinous junction
Chronic subdeltoid bursitis
Chronic subacromial bursitis
To dissolve calcifications in tendons or bursa

A diagnostic infiltration with a 1% procaine solution is performed in case of diagnostical doubt.
If the suspected lesion is infiltrated, pain on functional testing should disappear almost immediately, so confirming the diagnosis.

The musculotendinous junction of the supraspinatus is first infiltratred with procaine to confirm the diagnosis.
Somtimes two to three weekly infiltrations may prove curative. If not, the patient is referred for deep transverse frictions.

The chronic subdeltoid and subacromial bursitis are always infiltrated with procaine alone. This confirms the diagnosis. If no lasting benefit results after one infiltration, the lesion should be infiltrated with a mixture of procaine and trimacinolone.

Calcifications are dissolved by repeated infiltrations of a 2% procaine solution. This is only done if the calcifications are considered to be the cause of recurrent tendinitis or bursitis. An asymptomatic calcification is left alone.