Effect of subcutaneous tirzepatide vs placebo added to titrated insulin glargine on glycemic control in patients with type 2 diabetes: the SURPASS-5 randomized clinical trial
A shot typically causes little to no pain
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Technique Ultrasound-guided approach (preferred) Local Corticosteroid Injection at tendon sheath under Ultrasound guidance (see Shoulder Ultrasound) Approached in-plane to linear Ultrasound probe (probe short axis to anterior Shoulder - home position) Do not inject within tendon (and avoid circumflex artery within groove) Technique Landmark-based approach Images Landmarks Identify bicipital tendon in bicipital groove (proximal Humerus) Mark point of maximal tenderness over groove Injected with sterile technique (with Betadine preparation of skin) Direct needle parallel to bicipital groove (vertically oriented) Needle enters skin at 30 degrees oriented superiorly Do not inject bicipital tendon Infiltrate area around groove, but not into tendon Flow resisted when needle is inside tendon Withdraw needle slightly and retry Continue to withdraw until not in tendon Complications Bicipital tendon rupture Associated with intratendinous injection Do not inject bicipital tendon References
DOI:10.1016/j.burns.2004.10.013 6.Srensen.E, Cowland.J, Ganz.T, Borregaard.N, Wound healing and expression of antimicrobial peptides/polypeptides in human keratinocytes, a consequence of common growth factors
