British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 5, Issue.: 5
Original Research Article
Outcomes of Ultrasound-guided Glen Humeral Corticosteroid Injections in Adhesive Capsulitis
Amos Song1,2*, Jeffrey N. Katz1,3, Laurence D. Higgins1, Joel Newman4, Andreas Gomoll1 and Nitin B. Jain1,5,6,7
1Department of Orthopaedic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States.
2Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, Massachusetts, United States.
3Division of Rheumatology, Immunology, and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States.
4Department of Radiology, New England Baptist Hospital, Boston, Massachusetts, United States.
5Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, Massachusetts, United States.
6Harvard Shoulder Service, Harvard Medical School, Boston, Massachusetts, United States.
7Departments of Physical Medicine and Rehabilitation and Orthopaedics, Vanderbilt University Medical Center, United States.
Aims: To assess short and longer-term outcomes of ultrasound-guided glenohumeral corticosteroid injections for adhesive capsulitis.
Study Design: A mixed prospective and retrospective study design
Place and Duration of Study: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, between June 2011 and July 2012.
Methodology: Using medical records, we first retrospectively identified patients who had received ultrasound-guided injections of lidocaine and triamcinolone for adhesive capsulitis We then assessed short-term follow-up outcomes (within 3 months of procedure) using medical record review and phone interviews. Longer-term follow-up (at least 3 months from the procedure) outcomes were determined by mailings and phone calls. Average and worst shoulder pain scores were measured on a visual analog scale. Shoulder ROM was measured in forward flexion, isolated abduction, and external rotation.
Results: Patients presented an average of 5.1 (SD=4.1) months after onset of symptoms. Within three months of the injection, 55.9% (95% CI: 39.2%, 72.6%) of patients reported greater than 75% pain relief and 44.1% (95% CI: 27.4%, 60.8%) of patients reported greater than 75% ROM improvement. The percentage of patients who improved increased with increased duration of follow-up. At short-term follow-up (mean=2.1 months, SD=2.7), average pain decreased from 5.6 (SD=2.2) to 3.0 (SD=1.8) (p ≤ .001) and worst pain decreased from 7.8 (SD=1.2) to 4.3 (SD=3.2) (p ≤ .001). At longer-term follow-up (mean =10.4 months, SD=3.7), average pain decreased to 1.9 (SD=1.9) (p ≤ .001) and worst pain decreased to 2.9 (SD=2.3) (p ≤ .001).
Conclusion: A majority of patients had significant pain reduction and functional improvement after an ultrasound guided glenohumeral corticosteroid injection for adhesive capsulitis. Our patients experience the majority of their pain and functional relief within the first three months after an ultrasound-guided corticosteroid injection with continued increase in relief in the longer-term.
Ultrasound; corticosteroids; adhesive capsulitis; injections.
Full Article - PDF
DOI : 10.9734/BJMMR/2015/13478