Ultrasound-Guided Injections for Shoulder Bennett Lesions: Efficacy and Outcomes

This study aimed to describe the technique and short-term outcomes of ultrasound-guided injections for symptomatic Bennett lesions in baseball players. From August 2014 to August 2021, 13 ultrasound-guided injections were administered to 10 male baseball players, averaging 25 years of age. The group included major league and minor league pitchers, a second baseman, and one high school pitcher. All patients experienced posterior shoulder pain, especially during pitching activities, with symptoms like glenoid internal reduction deficit and reduced pitching velocity. The procedure was similar to a standard posterior glenohumeral injection but with the ultrasound transducer placed slightly medially, allowing for a lateral-to-medial needle approach. Anesthetic and steroid were injected onto the surface of the Bennett lesion, avoiding entry into the glenohumeral joint. MRI confirmed Bennett lesions in all cases, and ultrasound identified lesions in all but one. Among the injections, 67% of patients reported immediate symptom relief, though not all patients could assess changes immediately post-procedure, and one patient’s response was undocumented. No complications were observed. Data on average fastball velocity post-injection was available for two major league players; one pitcher saw a slight increase in velocity, while the other, injected late in the season, did not throw fastballs afterward. Two professional pitchers eventually underwent surgery, with neither returning to professional pitching. This study concludes that ultrasound-guided injections for Bennett lesions are a safe and effective procedure for temporary symptom relief, though the duration of benefit varies.