[The correlation between the accuracy of steroid injections and subsequent shoulder pain and function in subacromial impingement syndrome].
OBJECTIVE
We assessed the relationship between proper placement of corticosteroid injections and subsequent shoulder function and pain in subacromial impingement syndrome.


METHODS
The study included 48 patients (29 women, 19 men; mean age 46.5 years; range 23 to 58 years) with subacromial impingement syndrome, whose complaints of shoulder pain lasted more than two months. To monitor the site of injection, contrast material was added to a mixture of steroid and local anesthetic solution. Injections were delivered into the subacromial bursa by an anterolateral approach. Radiographs of the joint were taken immediately afterwards to ensure the accurate placement of the injection. Shoulder function and pain were evaluated by visual pain scale, range of movement of the joint, and Constant scores before treatment, and half an hour and two weeks after the injections.


RESULTS
The injections were placed accurately in 42 patients (87%), while in six patients (12.5%), delivery to the target site failed. Statistically significant improvements were observed in both groups half an hour after the injections (p<0.05). However, two weeks after the treatment evaluations showed that failure to obtain an accurate placement was associated with return to pretreatment values, while significant improvement continued in the other group.


CONCLUSIONS
Failure to deliver injections to the target site may be decreased by increased utilization of visualization and imaging methods.
Esenyel
Cem Zeki
CZ
SSK Bezm-i Alem Valide Sultan Vakuf Gureba Eğitim Hastanesi, Faith, Istanbul. esenyel@yahoo.com
Esenyel
Meltem
M
Yeşiltepe
Ridvan
R
Ayanoğlu
Semih
S
Bülbül
Murat
M
Sirvanci
Mustafa
M
Kara
Ayhan Nedim
AN
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D020069:Shoulder Pain / Q000000981:diagnostic imaging / Q000188:drug therapy; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003287:Contrast Media