title: Outcomes of Ultrasound-guided Glen Humeral Corticosteroid Injections in Adhesive Capsulitis.
abstract: OBJECTIVE
  To assess short and longer-term outcomes of ultrasound-guided glenohumeral corticosteroid injections for adhesive capsulitis.
  
  
  METHODS
  A mixed prospective and retrospective study design.
  
  
  METHODS
  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Department of Orthopaedic Surgery, Brigham and Women's Hospital, between June 2011 and July 2012.
  
  
  METHODS
  Using medical records, we first retrospectively identified patients who had received ultrasound-guided injections of lidocaine and triamcinolone for adhesive capsulitis We then assessed short-term follow-up outcomes (within 3 months of procedure) using medical record review and phone interviews. Longer-term follow-up (at least 3 months from the procedure) outcomes were determined by mailings and phone calls. Average and worst shoulder pain scores were measured on a visual analog scale. Shoulder ROM was measured in forward flexion, isolated abduction, and external rotation.
  
  
  RESULTS
  Patients presented an average of 5.1 (SD=4.1) months after onset of symptoms. Within three months of the injection, 55.9% (95% CI: 39.2%, 72.6%) of patients reported greater than 75% pain relief and 44.1% (95% CI: 27.4%, 60.8%) of patients reported greater than 75% ROM improvement. The percentage of patients who improved increased with increased duration of follow-up. At short-term follow-up (mean=2.1 months, SD=2.7), average pain decreased from 5.6 (SD=2.2) to 3.0 (SD=1.8) (p ≤ .001) and worst pain decreased from 7.8 (SD=1.2) to 4.3 (SD=3.2) (p ≤ .001). At longer-term follow-up (mean =10.4 months, SD=3.7), average pain decreased to 1.9 (SD=1.9) (p ≤ .001) and worst pain decreased to 2.9 (SD=2.3) (p ≤ .001).
  
  
  CONCLUSIONS
  A majority of patients had significant pain reduction and functional improvement after an ultrasound guided glenohumeral corticosteroid injection for adhesive capsulitis. Our patients experience the majority of their pain and functional relief within the first three months after an ultrasound-guided corticosteroid injection with continued increase in relief in the longer-term.
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States; Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, Massachusetts, United States.
authors.forename: Amos
authors.initials: A
authors.lastname: Song
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States.
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Higgins
authors.affiliation: Department of Radiology, New England Baptist Hospital, Boston, Massachusetts, United States.
authors.forename: Joel
authors.initials: J
authors.lastname: Newman
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gomoll
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, Massachusetts, United States; Harvard Shoulder Service, Harvard Medical School, Boston, Massachusetts, United States; Departments of Physical Medicine and Rehabilitation and Orthopaedics, Vanderbilt University Medical Center, United States.
authors.forename: Nitin B
authors.initials: NB
authors.lastname: Jain
keywords: Ultrasound; adhesive capsulitis; corticosteroids; injections