- Puncture of Shoulder Joint:
- posterior approach gives easy access to glenohumeral joint & avoids risk of damaging brachial plexus or cephalic vein;
- pt should be seated & entire shoulder, both anterior & posterior, should be prepped and draped;
- palpate most lateral edge of the acromion process;
- choose an entry site one cm medial and one cm distal to this;
- w/ other hand, palpate coracoid process anteriorly;
- now aim needle for coracoid process and it should enter joint;
- Puncture of the Subacromial Bursa:
- w/ patient seated, palpate postero-lateral portion of acromion and mark the skin 1-2 cm below this point;
- enter the skin at this point;
- there is no need for the needle to strike acromion;
- needle should pass easily under acromion;
- it is then in the subacromial bursa