scholarly journals Usefulness of combined handheld ultrasound and fluoroscopy-guided injection in adhesive capsulitis of the shoulder: A prospective, randomized single blind-pilot study

2021 ◽  
pp. 1-10
Author(s):  
Ki Deok Park ◽  
Jeong Won Ryu ◽  
Kyoung Rai Cho ◽  
Yongbum Park ◽  
Wook-Jin Chung
Keyword(s):  
Treatment Efficacy ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Pain Scale ◽  
Secondary Outcome ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Conventional Ultrasound ◽  
Handheld Ultrasound ◽  
Group B

BACKGROUND: Ultrasound is increasingly being utilized in the diagnosis and treatment of adhesive capsulitis. OBJECTIVE: To compare the therapeutic effects and advantages of combined handheld ultrasound and fluoroscopy-guided intra-articular corticosteroid injection with those of conventional ultrasound-guided corticosteroid injection in adhesive capsulitis of the shoulder. METHODS: A total of 39 patients diagnosed with adhesive capsulitis of the shoulder were randomly assigned into two groups. Group A patients (n= 19) underwent combined handheld ultrasound and fluoroscopy-guided corticosteroid injection and group B patients (n= 20) underwent conventional ultrasound-guided corticosteroid injection to the intra-articular space of the shoulder twice. Treatment efficacy was assessed at 2 and 6 weeks after the final injection, based on the verbal numeric pain scale, Shoulder Pain and Disability Index, and range of motion. Secondary outcome measures were the accuracy and procedure time. RESULTS: Both injection methods were effective in the treatment of adhesive capsulitis. No significant differences in treatment efficacy and injection accuracy were observed between the two groups (p> 0.05). CONCLUSIONS: This study showed no statistical differences in treatment efficacy between 2 groups. However, the combined use of ultrasound and fluoroscopy can increase the accuracy of injection compared with conventional ultrasound alone.

Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

2021 ◽  
pp. 193864002098092
Author(s):  
Gholamreza Raissi ◽  
Amin Arbabi ◽  
Maryam Rafiei ◽  
Bijan Forogh ◽  
Arash Babaei-Ghazani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Plantar Fascia ◽  
Numeric Rating Scale ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Double Blind

Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II

scholarly journals ADHESIVE CAPSULITIS; MANAGEMENT BY PHYSIOTHERAPY VERSUS INTRA-ARTICULAR CORTICOSTEROID INJECTION

2021 ◽  
Vol 71 (5) ◽  
pp. 1824-27
Author(s):  
Muhammad Umair Hashmi ◽  
Babar Bakht Chughtai ◽  
Muhammad Nadeem Ahsan
Keyword(s):  
Pain Score ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Sampling Technique ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Group A ◽  
Group B

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.

Comparison of clear effect and the complications, and short and mid-term effects between ultrasound-guided and non-guided catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 277-283
Author(s):  
Chengyan Zhu ◽  
Huawei Zhuo ◽  
Yi Qin ◽  
Weiwei Zhang ◽  
Junlan Qiu ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Arteriovenous Fistula ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Catheter Directed Thrombolysis ◽  
Before And After ◽  
Group A ◽  
Group B

Objective To compare the therapeutic effects of ultrasound-guided and non-guided catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity. Methods From August 2015 to April 2016, 60 patients with lower extremity deep venous thrombosis were randomly divided into two groups ( n = 30 for each) to receive catheter-directed thrombolysis. Group A was treated under the ultrasound guidance, while Group B was treated without guidance. Results Catheter-directed thrombolysis was successfully performed by only one intubate in Group A but by 5.9 intubates in Group B. It took 15.4 ± 3.2 min in Group A, significantly less than that in Group B (30.8 ± 6.6 min, p < 0.05). The incidences of hematoma were also remarkably different between the two groups (3.33% vs. 26.67%, p = 0.026). No pseudoaneurysm or arteriovenous fistula was found in Group A, but there were two cases of pseudoaneurysm and two cases of arteriovenous fistula in Group B (both 6.67%, p = 0.492). The circumference differences of the affected limb between before and after thrombolysis were 49.47 ± 2.484 mm in Group A, significantly higher than that in Group B (28.40 ± 2.856 mm, p < 0.001). After treatment, the venous unobstructed improvement rates and deep vein patency rate were both better than those in Group B (77 + 2.603% vs. 57.23 + 1.828% and 80% vs. 46.67%, respectively; p < 0.001). There were only three cases of PTS in Group A (10%, 3/30), but there were 11 cases in Group B (36.67%, 11/30). Conclusion Ultrasound-guided catheter-directed thrombolysis has advantages, with improvement of venous patency and decrease of the incidence of PTS.

scholarly journals Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Xiaoke Shang ◽  
Zhong Zhang ◽  
Xuelin Pan ◽  
Jian Li ◽  
Qi Li
Keyword(s):  
Internal Rotation ◽  
Adverse Reactions ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Adhesive Capsulitis ◽  
Risk Of Bias ◽  
Secondary Outcome ◽  
Significant Difference ◽  
Subgroup Analyses ◽  
Corticosteroid Injections

Background. Adhesive capsulitis is one of the most well-known causes of pain and stiffness of the shoulder. Corticosteroid injections have been used for many years. However, it is still controversial where corticosteroid should be injected, whether subacromial or intra-articular. Objective. The objective of this meta-analysis was to compare the effects of intra-articular (IA) and subacromial (SA) corticosteroid injections for the treatment of adhesive capsulitis. Materials and Methods. Four foreign databases and two Chinese databases were searched for RCTs and quasi-RCTs involving the comparison of IA and SA corticosteroid injection for the treatment of adhesive capsulitis. The Cochrane risk of bias tool and PEDro score were used to evaluate the quality of the studies. The primary clinical outcomes including VAS, Constant score, ASES score, and ROM were collected. The secondary outcome of corticosteroid-related adverse reactions was also compared between the two groups. The results were evaluated and compared at five time points. Subgroup analyses were performed to further explore the differences between groups. Results. Eight RCTs and one quasi-RCT, involving 512 participants, were identified and included in this meta-analysis. All studies were of low risk of bias and medium-high quality with the PEDro score ≥5 points. The pooled effect showed that there was no significant difference in the primary outcomes between IA injection and SA injection, with an exception of VAS at 2-3 weeks (P=0.02) and ROM of internal rotation at 8–12 weeks (P=0.02). According to the results of subgroup analyses, the differences of VAS and ROM of internal rotation did not last beyond the 2-3-week time period. Additionally, SA injection had the advantage of avoiding adverse reactions from the corticosteroid, especially in avoiding a large fluctuation of serum blood glucose levels. Conclusions. When corticosteroid injection is used to treat adhesive capsulitis, both injection sites can be selected. However, due to the scarcity of related studies, more rigorous trials are needed to confirm the current findings.

scholarly journals Ultrasound-guided injections for supraspinatus tendinopathy: corticosteroid versus glucose prolotherapy – a randomized controlled clinical trial

2017 ◽  
Vol 10 (3) ◽  
pp. 170-178 ◽  
Author(s):  
Brandi Cole ◽  
Patrick Lam ◽  
Lisa Hackett ◽  
George A. C. Murrell
Keyword(s):  
Clinical Trial ◽  
Corticosteroid Injection ◽  
Supraspinatus Tendon ◽  
Secondary Outcome ◽  
Controlled Clinical Trial ◽  
Ultrasound Guided ◽  
Shoulder Range Of Motion ◽  
Double Blinded ◽  
And Function

Background Subacromial corticosteroid injections are frequently performed for pain associated with supraspinatus tendinopathy. Glucose prolotherapy has been used clinically for multiple tendinopathies and is hypothesized to be an alternate injection therapy for supraspinatus tendinopathy. Methods A prospective, randomized, double blinded clinical trial was conducted. Thirty-six patients with supraspinatus tendinopathy were randomized into two groups: 17 received an ultrasound-guided injection of glucose into the tendinopathic parts of the supraspinatus tendon and 19 received an ultrasound-guided injection of corticosteroid into the subacromial bursa. Primary outcome was level of pain with overhead activities at 3 months. Secondary outcome measures included level and frequency of pain and function, shoulder range of motion, impingement tests, strength and tendon changes on ultrasound. Results Level of pain with overhead activities was significantly reduced at the 3-month follow-up in the prolotherapy group and at the 6-month follow-up for both the prolotherapy and corticosteroid groups. There were no significant differences between the groups at any time point. Conclusions Both glucose prolotherapy and corticosteroid were generally well tolerated; however, glucose prolotherapy offered no additional benefit over subacromial corticosteroid injection for supraspinatus tendinopathy.

scholarly journals Comparison between platelet rich plasma injection, corticosteroid injection and short-wave diathermy in the management of pain and the improvement of functional outcome in the patients suffering from adhesive capsulitis of the shoulder: a randomized controlled trial

2020 ◽  
Vol 7 (10) ◽  
pp. 1546
Author(s):  
Debasish Deb ◽  
Yumnam Singh Nandabir ◽  
Naorem Bimol Singh ◽  
Rakesh Das ◽  
Shanavas Anoth Meethal
Keyword(s):  
Randomized Controlled Trial ◽  
Range Of Motion ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Adhesive Capsulitis ◽  
Short Wave ◽  
Treatment Modalities ◽  
Secondary Outcome ◽  
Randomized Controlled

Background: Adhesive capsulitis of shoulder is characterized by pain and restricted range of motion and has a wide variety of treatment options without any substantial evidence. Platelet rich plasma (PRP) is one of the newer treatment modalities and its efficacy needs to be compared with other routine treatment modalities.Method: A randomized controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal for a period of 1-year February 2019 to January 2020. One hundred ninety-five patients with adhesive capsulitis recruited and randomized, patients received single PRP injection (2 ml) or corticosteroid (80 mg methyl prednisolone) or shortwave diathermy (10 settings continuous mode using 27.12 MHz).Results: The primary outcome measure was active range of motion of the shoulder and the secondary outcome measures included Visual analogue scale (VAS) for pain and a shortened version of Disabilities of the Arm, Shoulder and Hand (Quick DASH) for function. Patients were evaluated at 0, 3, 6 and 12 weeks. Chi-square test and ANOVA were used to determine significant differences. PRP treatment resulted in statistically significant improvement over corticosteroid at 12 weeks and over short-wave diathermy therapy at 6 weeks.Conclusion: This study demonstrates that single injection of PRP is more effective than corticosteroid or short-wave diathermy in the treatment of adhesive capsulitis of shoulder.

Ultrasound-Guided Percutaneous Needle Fenestration and Corticosteroid Injection for Anterior and Anterolateral Ankle Impingement

2017 ◽  
Vol 11 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Levon N. Nazarian ◽  
Nar V. Gulvartian ◽  
Erik C. Freeland ◽  
Wen Chao
Keyword(s):  
Soft Tissues ◽  
Telephone Survey ◽  
Corticosteroid Injection ◽  
Pain Scale ◽  
Ultrasound Guided ◽  
Ankle Pain ◽  
Common Cause ◽  
Ankle Impingement ◽  
Scale Levels ◽  
Foot Function

Background. Ankle impingement is a common cause of chronic ankle pain. We retrospectively studied the effectiveness of ultrasound-guided percutaneous needle fenestration of the pathological soft tissues combined with corticosteroid injection to treat this condition. Methods. We administered a telephone survey to patients who underwent the procedure. Patients were asked questions on the Foot Function Index and queried about their overall satisfaction with the procedure on a scale of 0 (completely unsatisfied) to 10 (very satisfied). Results. Forty-nine patients participated in the survey: 26 women and 23 men, mean age 42.7 years (range, 19-65 years). Impingement was anterior in 26/49 (53.1%), anterolateral in 14/49 (28.6%), and both in 9/49 (18.4%). Mean pain level before the procedure was 6.76 ± 1.84 and after the procedure was 2.73 ± 2.21. Reported pain scale levels declined by 4.02 ± 2 units after the procedure (P < .0001). Patient’s overall satisfaction was 7.9 ± 2.44. Conclusions. Ultrasound-guided percutaneous needle fenestration and corticosteroid injection appears to be an effective nonoperative alternative for treatment of anterior and/or anterolateral ankle impingement. Levels of Evidence: Level IV

Effectiveness of Ultrasound-Guided Corticosteroid Injection in the Treatment of Morton's Neuroma

2008 ◽  
Vol 29 (5) ◽  
pp. 483-487 ◽  
Author(s):  
Maja Markovic ◽  
Ken Crichton ◽  
John W. Read ◽  
Peter Lam ◽  
Henry Kim Slater
Keyword(s):  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

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