Table 2.

Pearls and Pitfalls

Criteria	Pearls	Pitfalls
Patient comfort	Ensure patients are comfortably seated with positioning that allows easy access to the shoulder (Fig 1)	Vasovagal syncope is a recognized complication of peripheral injections including those around the shoulder. Before starting the procedure, ensure that adequate facilities are available to manage this if it occurs.
Bleeding	The risk of bleeding is increased in patients on anticoagulant and antiplatelet medication. One should consider the risk/benefit ratio of using alternative diagnostic modality such as MRI in these patients vs stopping medication temporarily. If visualization is impaired by bleeding, exchange of fluid can be performed to improve it, but if unsuccessful the procedure should be terminated.	It is important to be aware that in-office needle arthroscopy does not currently offer options for control of intra-articular bleeding
Infection	The procedure should not be undertaken if there is local or systemic infection

MRI, magnetic resonance imaging.