title: Comparison of Sono-guided Capsular Distension with Fluoroscopically Capsular Distension in Adhesive Capsulitis of Shoulder.
abstract: OBJECTIVE
  To investigate the short-term effects and advantages of sono-guided capsular distension, compared with fluoroscopically guided capsular distension in adhesive capsulitis of shoulder.
  
  
  METHODS
  In this prospective, randomized, and controlled trial, 23 patients (group A) were given an intra-articular injection of a mixture of 0.5% lidocaine (9 ml), contrast dye (10 ml), and triamcinolone (20 mg); they received the injection once every 2 weeks, for a total of 6 weeks, under sono-guidance. Twenty-five patients (group B) were treated similarly, under fluoroscopic guidance. Instructions for the self-exercise program were given to all subjects, without physiotherapy and medication. Effects were then assessed using a visual numeric scale (VNS), and the shoulder pain and disability index (SPADI), as well as a range of shoulder motion examinations which took place at the beginning of the study and 2 and 6 weeks after the last injection. Incremental cost-effective ratio (ICER), effectiveness, preference, and procedure duration were evaluated 6 weeks post-injection.
  
  
  RESULTS
  The VNS, SPADI, and shoulder motion range improved 2 weeks after the last injection and continued to improve until 6 weeks, in both groups. However, no statistical differences in changes of VNS, SPADI, ROM, and effectiveness were found between these groups. Patients preferred sono-guided capsular distension to fluoroscopically guided capsular distension due to differences in radiation hazards and positional convenience. Procedure time was shorter for sono-guided capsular distension than for fluoroscopically guided capsular distension.
  
  
  CONCLUSIONS
  Sono-guided capsular distension has comparable effects with fluoroscopically guided capsular distension for treatment of adhesive capsulitis of the shoulder. Sono-guided capsular distension can be substituted for fluoroscopic capsular distension and can be advantageous from the viewpoint of radiation hazard mitigation, time, cost-effectiveness and convenience.
authors.affiliation: Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon 405-760, Korea.
authors.forename: Ki Deok
authors.initials: KD
authors.lastname: Park
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Nam
authors.forename: Tai Kon
authors.initials: TK
authors.lastname: Kim
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Kang
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Lim
authors.forename: Yongbum
authors.initials: Y
authors.lastname: Park