Usefulness of combined handheld ultrasound and fluoroscopy-guided injection in adhesive capsulitis of the shoulder: A prospective, randomized single blind-pilot study

J Back Musculoskelet Rehabil. 2022;35(4):901-910. doi: 10.3233/BMR-210170.

Abstract

Background: Ultrasound is increasingly being utilized in the diagnosis and treatment of adhesive capsulitis.

Objective: To compare the therapeutic effects and advantages of combined handheld ultrasound and fluoroscopy-guided intra-articular corticosteroid injection with those of conventional ultrasound-guided corticosteroid injection in adhesive capsulitis of the shoulder.

Methods: A total of 39 patients diagnosed with adhesive capsulitis of the shoulder were randomly assigned into two groups. Group A patients (n= 19) underwent combined handheld ultrasound and fluoroscopy-guided corticosteroid injection and group B patients (n= 20) underwent conventional ultrasound-guided corticosteroid injection to the intra-articular space of the shoulder twice. Treatment efficacy was assessed at 2 and 6 weeks after the final injection, based on the verbal numeric pain scale, Shoulder Pain and Disability Index, and range of motion. Secondary outcome measures were the accuracy and procedure time.

Results: Both injection methods were effective in the treatment of adhesive capsulitis. No significant differences in treatment efficacy and injection accuracy were observed between the two groups (p> 0.05).

Conclusions: This study showed no statistical differences in treatment efficacy between 2 groups. However, the combined use of ultrasound and fluoroscopy can increase the accuracy of injection compared with conventional ultrasound alone.

Keywords: Interventional ultrasound; fluoroscopy; frozen shoulder; intraarticular injection.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Bursitis* / diagnostic imaging
  • Bursitis* / drug therapy
  • Fluoroscopy
  • Humans
  • Injections, Intra-Articular
  • Pain Measurement
  • Pilot Projects
  • Prospective Studies
  • Range of Motion, Articular
  • Shoulder
  • Shoulder Joint*
  • Shoulder Pain / diagnostic imaging
  • Shoulder Pain / drug therapy
  • Shoulder Pain / etiology
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones