title: Targeted ultrasound-guided hydrodilatation via the rotator interval for adhesive capsulitis.
abstract: OBJECTIVE
  To describe and evaluate ultrasound-guided hydrodilatation via the rotator interval for the treatment of adhesive capsulitis.
  
  
  METHODS
  Patients referred to our department with adhesive capsulitis were consented for hydrodilatation. Inclusion criteria included a failure to respond to conservative treatment and the absence of full thickness rotator cuff tear. Twenty-one milliliters of a mixture of local anesthetic and steroid was injected into the rotator interval using a 21-gauge needle. Patients were followed up at 2 weeks and 4 months, with documented pain scores from 0 to 10 on a visual analogue scale and the Oxford Shoulder Questionnaire.
  
  
  RESULTS
  Twenty-two patients were suitable for inclusion in the study. Nineteen were female (86 %) and three were male. The mean age was 55 years (range, 32-71 years). The duration of symptoms ranged from 4 weeks to 20 months. At 4 months, 19/22 (86 %) of patients described either complete (7/22) or good (12/22) improvement in their symptoms. The mean pain score was 8.4 prior to the procedure, 3.1 at 48 h and 1.9 at 4 months, and 20/22 (91 %) had a lower pain score after 4 months. There was a statistically significant (p < 0.05) improvement in the Oxford shoulder score, from a mean of 13.6 pre-procedure to 36.5 at 4 months.
  
  
  CONCLUSIONS
  The rotator interval and anterior joint capsule are strongly implicated in the symptomatology of adhesive capsulitis. The novel use of targeted ultrasound-guided hydrodilatation via the rotator interval gives good results in reducing shoulder pain and symptoms in adhesive capsulitis.
authors.affiliation: Department of Radiology, Royal Berkshire Hospital, Reading, UK, philipyoong@gmail.com.
authors.forename: Philip
authors.initials: P
authors.lastname: Yoong
authors.forename: Stephen
authors.initials: S
authors.lastname: Duffy
authors.forename: David
authors.initials: D
authors.lastname: McKean
authors.forename: Nabil P
authors.initials: NP
authors.lastname: Hujairi
authors.forename: Ramy
authors.initials: R
authors.lastname: Mansour
authors.forename: James L
authors.initials: JL
authors.lastname: Teh
mesh_terms: D000328:Adult; D000368:Aged; D002062:Bursitis / Q000000981:diagnostic imaging* / Q000628:therapy*; D004106:Dilatation / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012782:Shoulder / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*