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
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More importantly, if you store your pen in a bathroom (a common habit), the temperature and humidity swings from hot showers can create conditions that stress the medication beyond what a kitchen counter would
J Nanobiotechnol 24 , 569 (2026)
Look for someone who has extensive experience with treating your specific condition, whether its knee pain , shoulder injuries , or arthritis
Clumping, stickiness, or color changes often indicate moisture absorption
