On Sat 14 Mar, Joe Gallagher wrote:
>
>
> Dr M Trowell wrote:
>
> > Did/do you use DM _with_ lidocaine? I would agree that it is extremely
> > painful without. Have also found physio good for non-responders. In an
> > ideal world physio for all........?
>
> I generally use Adcortyl with a hint of Xylocaine. I think that for a sucessful
> outcome to Tennis Elbow injection you must "fan out" and hit all the tender
> spots. When I was timid about these injections, often there was no improvement.
>
> With knee joints I was taught to approach anteriorly and always found this
> fraught with failure. Then I read in a book that the best approach for knee is
> just below the superior pole of the patella either laterally or medially and
> since I adopted this approach I have never had any trouble.
> Do any GPs on the list inject in or around the shoulder at all ? Is it easy ?
I find the posterior approach to the shoulder never fails, the
landmark is the acromion, you go in just under and direct forwards
towards the position of the Coracoid process, if necessary putting
your finger on it as an aiming mark. Usually slip in dead easily and
it is very painless.
Most satisfying are the rare acute calcific supraspinatus tendinitis cases where
the pain is really acute, terribly severe and a quick shot from the lateral
approach is much appreciated.
I always worry a bit about the Biceps tendon anteriorly although I suppose any
ruptures of LH Biceps tendon are likely to be degenerative and coincidental
rather than due to injection. (I hope!)
--
Allan Harris, GP, Haxby, York YO3 3PH
tel 01904-768666
work 01904-760125, fax 750168
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