Corticosteroid Injection for Subchondral Cyst in the Greater Tuberosity of the Shoulder Glenohumeral Joint

Evidence on Corticosteroid Injections for Glenohumeral Joint Conditions

The American Academy of Orthopaedic Surgeons (AAOS) cannot recommend for or against the use of injectable corticosteroids in the treatment of glenohumeral osteoarthritis (Grade I recommendation, Level V evidence) 1, 2, 3
Corticosteroid injections are widely used in clinical practice for patients with shoulder pain, often in conjunction with physical therapy as an initial treatment 2, 4
For glenohumeral joint conditions, corticosteroid injections may be administered into the glenohumeral joint or subacromial space 5, 6
Observational studies have shown significant short-term pain reduction after either glenohumeral or subacromial injection, but long-term pain reduction has not been verified 5, 6, 7

No specific high-quality studies address corticosteroid injections directly into subchondral cysts of the greater tuberosity in humans 1, 2

MRI is preferred to visualize the subchondral cyst and rule out other pathologies, and ultrasound may be used as a diagnostic tool for shoulder soft tissue injury 5, 6
Consider corticosteroid injection if patient has pain associated with the subchondral cyst and conservative measures have failed 1, 2, 5, 6
Monitor for short-term pain relief after injection, and continue appropriate physical therapy and rehabilitation 5, 6, 8

Injectable viscosupplementation may be considered as an option for glenohumeral osteoarthritis (Grade C recommendation, Level IV evidence) 1, 2, 3
For persistent pain, surgical options may be considered depending on the extent of pathology and patient factors 1, 2, 4

The evidence specifically for subchondral cysts in the greater tuberosity is extremely limited 1, 2, 3
Potential complications of corticosteroid injections include post-injection pain flare 6