Acromioclavicular Joint Injection

Most shoulders are examined with the patient seated. There is no need to change position prior to injection. The needle is targeted on the rounded poorly reflective joint space.

Joint Identification

The AC joint is easily identified in the coronal plane. If there is any subluxation present, the lateral aspect of the joint is open to an approach from the lateral side.

Sagittal Plane Approach

If there is no malalignment or effusion, the joint is best injected in the sagittal plane:
  1. Place the probe medial to the joint and identify the clavicle
  2. Move the probe laterally until the bony reflection disappears indicating that the probe is now positioned directly over the joint
  3. Further lateral movement brings the bony acromion into view
  4. Return the probe to overlie the joint either anteriorly or posteriorly
  5. Insert the needle at 90 degrees to the probe in the sagittal plane

Key Technical Points

  • Patient positioning: seated, no position change required
  • Target: rounded poorly reflective joint space
  • Coronal plane for initial identification
  • Sagittal plane for injection when no malalignment present
  • 90-degree needle insertion angle

Injection Images

ACJ injection technique images and ultrasound guidance will be displayed here
(Original image: ../Images/ACJ inj.png)