Optimizing Scapulothoracic Ultrasound-Guided Injections: The Role of Hand Positioning in Enhancing Procedural Ease

Pathologies of scapulothoracic articulation, such as crepitus and bursitis, often lead to painful symptoms that may persist despite conservative treatments. In such cases, image-guided injections may be necessary. However, the scapulothoracic space can be difficult to access due to the proximity of the scapula to the thoracic wall, making the procedure challenging. This study aimed to evaluate the effect of different hand positions on scapulothoracic distance during ultrasound, with the goal of determining which position enhances the accessibility of the area for injections. Ten healthy adult volunteers with no history of scapulothoracic issues, trauma, or shoulder surgery were included in the study. Two musculoskeletal radiologists measured the scapulothoracic distance using ultrasound in three hand positions: hands under the head, hands by the side of the trunk, and hands hanging by the side of the couch. Data were analyzed using SPSS. Although no statistically significant differences were found between the hand positions, both radiologists noted that the second and third positions provided better access for interventions. The increase in scapulothoracic distance in the hands-by-the-side and hands-hanging positions suggested potential clinical benefits, although further research with larger sample sizes is needed to establish clear guidelines for optimizing scapulothoracic injections. These findings emphasize the importance of hand positioning to improve procedural ease during ultrasound-guided therapeutic interventions.