Efficacy of ultrasonography-guided intra-articular steroid injection of the shoulder and excercising in patients with adhesive capsulitis: Glenohumeral versus subacromial approaches

To evaluate the efficacy of intra-articular steroid injection of the shoulder joint with exercises in the management of patients with adhesive capsulitis and to compare glenohumeral (GH) versus subacromial subdeltoid (SASD) ultrasound-guided approaches. Forty patients with adhesive capsulitis were r...

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Bibliographic Details
Published in:	Egyptian rheumatologist Vol. 40; no. 4; pp. 277 - 280
Main Authors:	Khallaf, Soha F., Hussein, Mervat I., El-Barbary, Amal M., El Khouly, Radwa M.
Format:	Journal Article
Language:	English
Published:	Elsevier B.V 01-10-2018
Subjects:	Adhesive capsulitis Glenohumeral Subacromial subdeltoid bursa Ultrasound-guided injection Glenohumeral Subacromial subdeltoid bursa Adhesive capsulitis Ultrasound-guided injection
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Summary:	To evaluate the efficacy of intra-articular steroid injection of the shoulder joint with exercises in the management of patients with adhesive capsulitis and to compare glenohumeral (GH) versus subacromial subdeltoid (SASD) ultrasound-guided approaches. Forty patients with adhesive capsulitis were randomly divided into 2 groups according to injection approach. Patients received ultrasound-guided intra-articular injection methylprednisolone acetate (40 mg) and 1 ml 2% lidocaine followed by exercise for 12 weeks. Visual analog scale (VAS) for pain, the shoulder pain and disability index (SPADI) and active range of motion (ROM) were assessed before and 12 weeks post-injection. The mean age of the patients was 47.3 ± 8.7 years with 12 females and 8 males in each group. After injection, there was a significant improvement of pain (VAS) and SPADI in both groups (p < 0.001). Before injection, SASD bursitis was present in 18 (45%), GH joint effusion in 14 (35%), rotator cuff tendinopathy in 6 (15%), bursitis with effusion in 1 (2.5%) and with supraspinatus tendon calcification in another (2.5%). Both groups significantly equally improved regarding to ROM compared to before injection. Post-injection, the SPADI significantly improved in the SASD group compared to GH; with remarkable improvement in the joint extension, internal and external rotation (p < 0.001). Intrarticular steroid injection of the shoulder joint followed by exercises in patients with adhesive capsulitis decreases pain, improves function and ROM with a more favorable response by the GH approach. Ultrasound-guided injection is an accurate, easy and cost-effective approach.
ISSN:	1110-1164 2090-2433
DOI:	10.1016/j.ejr.2018.01.005