Background: Adhesive capsulitis is a common but poorly understood disorder of
the shoulder. Various treatments have been developed to manage this condition, but
the efficacy of these treatments is controversial. We developed an ultrasound-guided,
minimally invasive interventional technique to manage adhesive capsulitis of the shoulder
using a specially designed needle.
Objective: To describe the methodological approach of our intervention.
Study Design: Technical report.
Setting: Pain management clinic.
Methods: Thirteen participants with adhesive capsulitis of the shoulder underwent
ultrasound-guided interventional release of the rotator interval and posteroinferior capsule
using a specially designed curved Round Needle. A convex ultrasound probe was placed
along the oblique coronal plane over the supraspinatus muscle and acromion. Under
ultrasonographic guidance, the needle was passed through the supraspinatus muscle and
superior labrum and reached the rotator interval. It was moved forward and backward
until no resistance was felt. After finishing the rotator interval release, the needle was
inserted toward the posteroinferior capsule. While the operator released the adhesion
in the posteroinferior capsule by moving the needle forward and backward, an assistant
gradually abducted the shoulder. When full abduction of the affected shoulder was
achieved, the intervention was completed.
Results: Following our intervention, significant improvements in pain levels, glenohumeral
range of motion, and Quick Disability of the Arm, Shoulder, and Hand scores were attained
at follow-up.
Limitations: Technical report only. Efficacy of this technique is beyond the scope of the
article.
Conclusion: Ultrasound-guided interventional release of the rotator interval and
posteroinferior capsule appears to have clinical significance in the management of adhesive
capsulitis of the shoulder.
Key words: adhesive capsulitis, shoulder, ultrasound, intervention, dry needling,
technique