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There is no standard protocol to publish here, because no human trial has defined one

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

When to Consider Testing Testing may be useful: Before starting a GLP-1 medicine After a meaningful treatment change When diabetes goals are not being met When persistent gastrointestinal symptoms develop When food or fluid intake has significantly decreased When kidney or liver risk is already present When a prior result was abnormal When a healthcare provider recommends follow-up Testing frequency should be based on individual risk rather than an automatic monthly or quarterly panel for everyone

Disclaimer For laboratory research use only

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