Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique.
Lee H-J, Lim K-B, Kim D-Y, Lee K-T. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique.


OBJECTIVE
To evaluate the clinical effect of ultrasonography (US)-guided intra-articular injections compared with a blind (unguided) technique for the treatment of adhesive capsulitis.


METHODS
Randomized controlled trial.


METHODS
Outpatient rehabilitation clinic.


METHODS
Patients (N=43) diagnosed as having adhesive capsulitis after clinical examinations and radiologic and ultrasonographic study.


METHODS
Under either US-guided or a blind technique, patients received a 20-mg intra-articular injection of triamcinolone mixed with 1.5mL 2% lidocaine and 4mL normal saline in the first week followed by 5 weekly injections of sodium hyaluronate.


METHODS
A visual analog scale for pain intensity, range of motion (ROM) of the shoulder (flexion, abduction, external rotation, and internal rotation), and general shoulder function during daily activities at preinjection as a baseline and then every week after injection for 6 weeks for each patient.


RESULTS
Twenty patients out of 22 in the blind injection group and 20 out of 21 in the US-guided group finished the entire 6-week study period. The improvement in pain intensity, ROM, and shoulder function score was significantly greater in the US-guided injection group than in the blind injection group by the second week postinjection (P<.05). However, there were no further significant differences in the improvement between the 2 groups beyond the third week.


CONCLUSIONS
US-guided intra-articular injections may offer advantages over a blind technique for the treatment of adhesive capsulitis and may deliver clinical benefits during the first few weeks of treatment. This finding suggests that the improved targeting to the intra-articular space by using US can result in better treatment of adhesive capsulitis.
Lee
Hong-Jae
HJ
Department of Rehabilitation Medicine, Ilsan-Paik Hospital, Inje University, and Institute of Sports Rehabilitation, Inje University, Goyang city, Gyonggi-do, South Korea. honglee@paik.ac.kr
Lim
Kil-Byung
KB
Kim
Dug-Young
DY
Lee
Kyung-Tae
KT
D000779:Anesthetics, Local / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002062:Bursitis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007270:Injections, Intra-Articular / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D014221:Triamcinolone / Q000008:administration & dosage; D018084:Ultrasonography, Interventional; D055675:Viscosupplements / Q000008:administration & dosage
D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D055675:Viscosupplements; D014221:Triamcinolone; D006820:Hyaluronic Acid; D008012:Lidocaine