Shoulder Injection/Aspiration

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Removing fluid from the shoulder (joint aspiration) for laboratory testing can help a doctor diagnose the nature and severity of a patient's condition. Some types of conditions, such as tendonitis or bursitis, benefit from the injection of medications into the joint space. Joint injections or aspirations are usually done under local anesthesia in the doctor's office or in a hospital. Shoulder injections may require the aid of an X-ray called fluoroscopy for guidance.

Need to Know

Nice to Know
  • You will be asked to sign a consent form before the procedure is performed
  • Tell your radiologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • If you are taking a blood thinner or aspirin product, the physician will instruct you when to stop taking these medications
  • Inform your radiologist if you are pregnant
  • Wear comfortable, loose-fitting clothing
  • You can request a gown to wear during your treatment
  • You can go home after the procedure if vitals are stable
  • Most patients feel minimal discomfort after the procedure


How Does It Work?

Using image-guidance from fluoroscopy (X-rays that show motion inside your body in real-time) or CT scans, your doctor will place a needle into the shoulder joint and inject steroid medication to help reduce swelling and alleviate pain. To aspirate the shoulder joint a needle is placed in the joint and fluid is aspirated and a sample is sent to the lab for analysis.

What Happens — Before, During, and After?

A clinical staff member will bring you into the pre-procedure area and may ask you to change into a gown. Your doctor will greet you, review the procedure, and answer any questions you may have. You will be brought into the procedure room, and you will be positioned on the procedure table.

The technologist will sterilize, and cover the area of your body where the needle will be inserted with a surgical drape. A local anesthetic is administered to numb the area where the needle will be placed. Once the area is numb, your doctor will advance the needle into your joint using image guidance. A small amount of x-ray dye can be injected to confirm needle placement. Once the needle is in the joint the medication can be injected or fluid can be aspirated. You might feel some discomfort as the medication is being administered. This should only last a short moment and will most likely dissipate as soon as the injection is complete. Once the medicine has been administered you may feel some tingling. You should tell your doctor if you feel any sharp pain.

The procedure takes approximately 30 minutes.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or – as you’re doing now- educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a clinical staff member from the Interventional Radiology Department will call you. The clinical staff member will give you any additional instructions, and will ask if you have any questions.
  • Take your medications as instructed
  • When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics, or x-ray dye (contrast media). If there’s any chance you might be pregnant, tell your radiologist.
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What Should I Bring?

On the day of your procedure you should:

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of Shoulder Injection/Aspiration could be:

  • Relief of shoulder pain
  • Reduced inflammation which may lead to healing
  • Joint aspiration is usually performed as a diagnostic or therapeutic procedure

Risks you should be aware of include:

  • As with any procedure there is a slight risk of infection
  • Rarely, this procedure can cause a temporary increase in pain
  • Rarely there are reactions to the pain medication such as rash
  • There is a slight risk of nerve damage at the injection site
  • There is a slight risk of bleeding
  • If fluoroscopy is used, there are risks associated with exposure to X-rays. You should discuss this with your physician

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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