A Retrospective Study of Ultrasound-guided Hydrodilatation of Glenohumeral Joint Combined with Corticosteroid Injection in Patients with Frozen Shoulder.

Objective The purpose of this study was to establish the efficacy of ultrasound (US)-guided hydrodilatation of the glenohumeral joint, in conjunction with corticosteroid injection, in alleviating pain and improving shoulder joint adhesion among patients with primary frozen shoulder (FS). Background: FS, also known as adhesive capsulitis, is a pathological condition characterized by pain and potential functional impairment. The natural progression of FS involves three distinct stages: freezing, frozen, and thawing. Chronic pain in FS patients can lead to aseptic inflammation, thickening of fibroblasts, and an abundance of type I and III collagen fibers in the vicinity of the glenohumeral joint, ligaments, and tendons. This condition significantly impacts patients' quality of life. Methods A total of 200 FS patients were enrolled in this study. All participants underwent US-guided hydrodilatation of the glenohumeral joint, combined with corticosteroid injection, at our department. Pre- and post-treatment (1 year) ultrasound measurements were recorded for the thickness of the axillary recess capsule (ARC), coracohumeral ligament (CHL), and subacromial bursa. Additionally, the numerical rating scale (NRS) and Constant-Murley score (CMS) were assessed to evaluate pain intensity and shoulder function, respectively. Results Prior to the commencement of treatment, the measurements indicated a thickness of 4.8±2.3 mm for the ARC, 4.2±1.7 mm for the CHL, and 3.9±1.4 mm for the subacromial bursa. Additionally, the preoperative assessment using the NRS scale for pain yielded a score of 6.4±2.0, while the CMS score for the joint function was 35.8±8.5. Following one year of treatment, a notable decrease was observed in the thickness of ARC, CHL, and subacromial bursa. Furthermore, significant improvements were recorded in both the pain NRS score and the CMS score. Conclusion US-guided hydrodilatation of the glenohumeral joint, in combination with corticosteroid injection, may help improve the symptom and function of FS.

Zeng Z ，Zhu J 《Current Medical Imaging》

A team approach to adhesive capsulitis with ultrasound guided hydrodilatation: a retrospective study.

Dakkak M ，Genin J ，Wichman L ，Zhang C ，Patel V ... -  《-》

Ultrasonography-guided corticosteroid injection in the coracohumeral ligament in patients with adhesive capsulitis of the shoulder: a double-blinded, sham-controlled randomized study.

Contracture and thickening of the coracohumeral ligament (CHL) occur in patients with adhesive capsulitis. This adversely affects the movement and function of the shoulder joint. There is limited evidence that explores the effectiveness of an isolated steroid injection into the CHL in combination with physical therapy. This prospective randomized control trial aimed to evaluate the clinical effects of ultrasonography-guided corticosteroid injection compared to a sham injection into the CHL in subjects with adhesive capsulitis. Forty patients (23 males, 52.2 ± 8 years of age) with unilateral adhesive capsulitis (with 5.4 ± 2 months' mean duration of symptoms) were randomly assigned to either the experimental or control group. Both groups received ultrasonography-guided injections into the CHL. The experimental group (n = 20) received corticosteroids and the control group (n = 20) received a sham lidocaine injection. All subjects underwent supervised conventional physical therapy 3 times a week for 3 months. Subjects were evaluated for improvements in pain, range of motion, and disability at 6 and 12 weeks compared with preinjection baseline measurements. Data were compared statistically across groups and times at P < .05. The CHL thickness was compared at baseline across sides using paired t tests. The experimental group showed statistically greater improvements in pain, functional scores, flexion, abduction, and internal and external rotation range of motion at 12 weeks compared with the control group. Pain reduction was observed in both groups at 6 and 12 weeks, but the experimental group exhibited significantly greater reductions. The CHL was significantly thicker on the affected side than on the unaffected side (P < .001). This study partially supported the hypothesis. Notably, significant improvements in pain, range of motion, and functional scores were observed at 12 weeks in the experimental group. The greater improvements in pain and external rotation may have resulted in lower disability scores in the experimental group. The results emphasize the importance of targeted intervention into the CHL.

Singh H ，Rathore LPS ，Salimath S ，Makhija M ，Phadke V ... -  《-》

Similar short-term outcomes of ultrasound guided posterior intra-articular and anterior extra-articular corticosteroid injection in the treatment of primary frozen shoulder. A randomized controlled, single-blind study.

Sensoz E ，Sevım OF ，Cakmak H ，Edız SS ，Ecevız E ，Ergun S ... -  《-》

Additive effect of glenohumeral joint hydrodilatation applied in addition to suprascapular nerve blockage in patients with adhesive capsulitis.

We aimed to investigate the efficacy of shoulder hydrodilatation (HD) applied in addition to suprascapular nerve blockage (SSNB) on severity of pain, shoulder joint range of motion (ROM), functional status, handgrip (HG) strength in patients with adhesive capsulitis (AC). Forty-eight patients who were diagnosed with AC based on physical examination findings included in the study. The patients were randomized into two groups as combination of SSNB + HD and SSNB alone. Injections were performed under ultrasonography guidance. Shoulder ROM angles were measured with a goniometer. Pain intensity was evaluated with visual analog scale. Functional status was evaluated with Quick Disability of Arm, Shoulder, and Hand (QDASH). HG strength was measured by a Jamar dynometer. After the injection, a home-based exercise program was given to all patients. Patients were evaluated at baseline, 1st and 3rd month. Abduction and external rotation ROM angles were statistically significantly limited in SSNB group, at baseline (p = 0.020, p = 0.018, respectively). In terms of other parameters, both groups were similar at baseline (p > 0.05). At comparison of baseline-1st month, a significant improvement was observed in VAS score, abduction and flexion ROM and QDASH score, in both groups (p < 0.05), however, there was no statistically significant difference between the groups. There is a statistically significant decrease in VAS score in both groups, at all times, but, no significant difference between the groups. At the comparison of baseline-3rd month measurements, it was observed that all of the parameters significantly improved in both groups, and there was no statistically significant difference between the groups except for abduction and external rotation ROM (p > 0.05). Abduction ROM and external rotation ROM were significantly higher in the SSNB group than SSNB + HD group at 3rd month. Both SSNB + HD and SSNB alone provide significant improvement clinically especially in shoulder pain. HD added to SSNB does not seem to provide any additional benefit. SSNB is an effective treatment option for up to 3 months in patients with AC, mainly in abduction and external rotation limitation.

Mülkoğlu C ，Tiftik T ，Deniz AB ，Kandaşoğlu H ，Genç H ... -  《BMC MUSCULOSKELETAL DISORDERS》