scholarly journals Comparison of Clinical Outcomes between Idiopathic Frozen Shoulder and Diabetic Frozen Shoulder After a Single Ultrasound-Guided Intra-Articular Corticosteroid Injection

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 370
Author(s):  
Chul-Hyun Cho ◽  
Hyo-Joon Jin ◽  
Du Hwan Kim
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
Glenohumeral Joint ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Corticosteroid Injections

There is no consensus on the use of intra-articular corticosteroid injections in diabetic frozen shoulder (FS). Thus, we aimed to compare clinical outcomes after intra-articular corticosteroid injections in patients with diabetic FS and idiopathic FS. Data collected from 142 FS patients who received glenohumeral joint intra-articular corticosteroid injections were retrospectively reviewed. Thirty-two patients were diagnosed with diabetic FS and 110 patients with idiopathic FS. Data including visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and passive range of motion (ROM) were compared before the injection and at 3, 6, and 12 weeks after the injection. There were significant improvements in all outcomes (p < 0.001 for all parameters) through 12 weeks in both groups. There were no significant differences in all outcomes, except for ASES scores, between both groups at 3 weeks. However, there were significant differences in VAS score, SSVs, ASES scores, and passive ROMs, except for angle of abduction, between the two groups at 6 weeks and 12 weeks after injection. A single intra-articular steroid injection can be used as a conservative treatment for diabetic FS, but less effective than for idiopathic FS.

scholarly journals Does Single Blind Anterior Glenohumeral Steroid Injection Performed by Short Experienced Clinicians Could Provide Clinical Efficacy in Patients with Frozen Shoulder?

2014 ◽  
Vol 17 (3) ◽  
pp. 102-106
Author(s):  
Jin Ho Hong ◽  
Ho Young Ryu ◽  
Yong Bok Park ◽  
Sang Jun Jeon ◽  
Won Ha Park ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Glenohumeral Joint ◽  
Steroid Injection ◽  
External Rotation ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Analog Scale ◽  
The Mean ◽  
Frozen State

BACKGROUND: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients.METHODS: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days.RESULTS: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment.CONCLUSIONS: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.

scholarly journals Effectiveness of Blind & Ultrasound Guided Corticosteroid Injection in Impingement Syndrome

2015 ◽  
Vol 8 (7) ◽  
pp. 179 ◽  
Author(s):  
Shila Haghighat ◽  
Parisa Taheri ◽  
Mohsen Banimehdi ◽  
Arash Taghavi
Keyword(s):  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Medical Science ◽  
Impingement Syndrome ◽  
Control Group ◽  
Case Group ◽  
Ultrasound Guided ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Corticosteroid Injections

<p>Local steroid injections are common for treatment of impingement syndrome. Corticosteroid injections methods are basically in two formats, blind or with image guidance. The aim of this study is to compare the effect of ultrasound-guided in comparison with blind corticosteroid injections in patients with impingement syndrome. This study is a randomized clinical trial study undertaken in patients with diagnosis of impingement syndrome done in Isfahan University of Medical Science clinics from February 2014 to February 2015. The number of all patients registered in the study is 48; and then 40 patients were allocated to either control group randomly which received blind steroid injection or case group that underwent ultrasound-guided steroid injection. The clinical symptoms were assessed using Shoulder Pain and Disability Index (SPADI) questionnaire, Visual Analogue Scale (VAS) and shoulder range of motion (ROM) using goniometer at baseline and six weeks after the injection. Data analysis revealed a significant difference in the mean of the VAS, SPADI and shoulder ROM in both groups 6 weeks after intervention (P &lt; 0.05). Patients with ultrasound guided corticosteroid injection had statistically significant improvements in function and shoulder ROM (abduction, flexion) compared to blind injection group after 6 weeks (P&lt;0.05). There was not significant differences in pain (VAS) and internal and external rotation between these two groups (p&gt;0.05). Our findings suggest that US image guided can improve the shoulder function of patients with impingement syndrome, and thus can be considered in comprehensive care programs of these patients for fast speed of rehabilitation.</p>

scholarly journals Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

2021 ◽  
Vol 24 (2) ◽  
pp. 55-65
Author(s):  
Su Cheol Kim ◽  
Sang Min Lee ◽  
Gun Tae Park ◽  
Min Chang Jang ◽  
Jae Chul Yoo
Keyword(s):  
Clinical Outcomes ◽  
Steroid Injection ◽  
Calcific Tendinitis ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Subjective Satisfaction ◽  
Group A ◽  
Group B ◽  
Needle Decompression ◽  
Repeat Procedures

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures.Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed.Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, P=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6–8] vs. 8 [interquartile range, 7–9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001].Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

scholarly journals Relative Efficacy of Three of Nonsurgical Treatments for Calcific Tendinitis: Physical Therapy vs Steroid Injection vs Ultrasound-Guided Aspiration

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Mauricio Drummond ◽  
Caroline Ayinon ◽  
Albert Lin ◽  
Robin Dunn
Keyword(s):  
Physical Therapy ◽  
Rotator Cuff ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Ultrasound Guided ◽  
Calcium Deposits

Objectives: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC) that accounts for up to 7% of cases of shoulder pain1. The most common conservative treatments typically include physical therapy (PT), corticosteroid injection (CSI), or ultrasound-guided aspiration (USA). When conservative management fails, the patient may require arthroscopic surgery to remove the calcium with concomitant rotator cuff repair. The purpose of this study was to characterize the failure rates, defined as the need for surgery, of each of these three methods of conservative treatment, as well as to compare post-operative improvement in patient-reported outcomes (PROs) – including subjective shoulder values (SSV) and visual analog scale (VAS) pain scores – based on the type of pre-operative conservative intervention provided. A secondary aim was to compare post-operative range of motion (ROM) outcomes between groups that failed conservative management. We hypothesized that all preoperative conservative treatments would have equivalent success rates, PROs, and ROM. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA. 1941;116(22):2477-2489. Methods: A retrospective review of all patients who were diagnosed with calcific tendinitis at our institution treated among 3 fellowship trained orthopedic surgeons between 2009 and 2019 was performed. VAS, SSV, and ROM in forward flexion (FF) and external rotation (ER) was abstracted from the medical records. Scores were recorded at the initial presentation as well as final post-operative follow-up visit for those who underwent surgery. The conservative treatment method utilized by each patient was recorded and included PT, CSI, or USA. Failure of conservative management was defined as eventual progression to surgical intervention. Statistical analysis included chi-square, independent t test and ANOVA. Descriptive statistics were used to report data. A p<0.05 was considered to be statistically significant. Results: 239 patients diagnosed with calcific tendinitis were identified in the study period with mean age of 54 years and follow up of at least 6 months. In all, 206 (86.2%) patients underwent a method of conservative treatment. Of these patients, 71/239 (29.7%) underwent PT, 67/239 (28%) attempted CSI, and 68/239 (28.5%) underwent USA. The overall failure rate across all treatment groups was 29.1%, with injections yielding the highest success rate of 54/67 (80.6%). Physical therapy saw the highest failure rate, with 26/71 (36.7%) proceeding to surgical intervention. Patients undergoing physical therapy were statistically more likely to require surgery compared to those undergoing corticosteroid injection (RR 1.88, p= 0.024). Of all 93 patients who underwent surgery, VAS, SSV, ROM improved significantly in all groups. On average, VAS decreased by 4.02 points (6.3 to 2.3), SSV increased by 33 points (51 to 84), FF improved by 13.8º, and ER improved 8.4º between the pre- and post-operative visits (p<0.05). The 33 patients who did not attempt a conservative pre-operative treatment demonstrated the largest post-operative improvement in VAS (-6.00), which was significantly greater than those who previously attempted PT (-3.33, p<0.05). There was a trend towards greater improvement in SSV in the pre-operative PT group (45 to 81) compared to others, but this did not reach statistical significance (p=0.47). Range of motion was not significantly affected by the method of pre-operative conservative intervention. Conclusions: Conservative treatment in the form of physical therapy, corticosteroid injection, and ultrasound-guided aspiration is largely successful in managing calcific tendinitis of the shoulder. Of these, PT demonstrated the highest rate of failure in terms of requiring surgical management. PRO improvement varied among the conservative modalities used, however patients who did not attempt conservative management experienced the greatest improvements following surgery. If surgery is necessary following failed conservative treatment, excellent outcomes can be expected with significant improvements in ROM and PROs. This information should be considered by the surgeon when deciding whether to recommend conservative treatment for the management of calcific tendinitis, as well as which specific method to employ.

scholarly journals A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

2018 ◽  
Vol 5 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Alok Pandey ◽  
B Shrestha ◽  
K M Shrestha
Keyword(s):  
Range Of Motion ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Equal Frequency ◽  
Steroid Injections ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Dominant Side

BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B.   In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28 

scholarly journals Changes in Abduction and Rotation Range of Motion in Response to Simulated Dorsal and Ventral Translational Mobilization of the Glenohumeral Joint

2002 ◽  
Vol 82 (6) ◽  
pp. 544-556 ◽  
Author(s):  
Ar-Tyan Hsu ◽  
Tom Hedman ◽  
Jia Hao Chang ◽  
Chuong Vo ◽  
Larry Ho ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Glenohumeral Joint ◽  
Physical Therapists ◽  
Frozen Shoulder ◽  
Testing System ◽  
Before And After ◽  
Medial Rotation ◽  
Fresh Frozen ◽  
Lateral Rotation ◽  
Improved Function

AbstractBackground and Purpose. Translational mobilization techniques are frequently used by physical therapists as an intervention for patients with limited ranges of motion (ROMs). However, concrete experimental support for such practice is lacking. The purpose of the study was to evaluate the effect of simulated dorsal and ventral translational mobilization (DTM and VTM) of the glenohumeral joint on abduction and rotational ROMs. Methods. Fourteen fresh frozen shoulder specimens from 5 men and 3 women (mean age=77.3 years, SD=10.1, range=62–91) were used for this study. Each specimen underwent 5 repetitions of DTM and VTM in the plane of scapula simulated by a material testing system (MTS) in the resting position (40° of abduction in neutral rotation) and at the end range of abduction with 100 N of force. Abduction and rotation were assessed as the main outcome measures before and after each mobilization procedure performed and monitored by the MTS (abduction, 4 N·m) and by a servomotor attached to the piston of the actuator of the MTS (medial and lateral rotation, 2 N·m). Results. There were increases in abduction ROM for both DTM (X̄=2.10°, SD=1.76°) and VTM (X̄=2.06°, SD=1.96°) at the end-range position. No changes were found in the resting position following the same procedure. Small increases were also found in lateral rotation ROM after VTM in the resting position (X̄=0.90°, SD=0.92°, t=3.65, P=.003) and in medial rotation ROM after DTM (X̄=0.97°, SD=1.45°, t=2.51, P=.026) at the end range of abduction. Discussion and Conclusion. The results indicate that both DTM and VTM procedures applied at the end range of abduction improved glenohumeral abduction range of motion. Whether these changes would result in improved function could not be determined because of the use of a cadaver model.

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.

Changes in Range of Motion after Intra-Articular Corticosteroid Injection in Frozen Shoulder: A Retrospective 3-Month Follow-Up Study

Clinical Pain ◽  
2019 ◽  
Vol 18 (2) ◽  
pp. 76-81
Author(s):  
Hyoung Jun Cho ◽  
Seung-Hyun Yoon ◽  
Minchul Kim ◽  
Dae Hwan Kim
Keyword(s):  
Range Of Motion ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Follow Up Study

scholarly journals Efficacy of a Single Corticosteroid Injection for Morton's Neuroma in Adults: A Systematic Review

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Steven R. Edwards ◽  
Susannah Fleming ◽  
Karl B. Landorf
Keyword(s):  
Primary Outcome ◽  
Event Rate ◽  
Corticosteroid Injection ◽  
Adverse Event Rate ◽  
Ultrasound Guided ◽  
Medium Term ◽  
Morton’S Neuroma ◽  
Morton's Neuroma ◽  
Corticosteroid Injections

Background Morton's neuroma is a common condition that routinely presents in podiatric practice. The aim of this study was to systematically synthesize the evidence relating to the effectiveness of a corticosteroid injection for Morton's neuroma. Methods Studies with a publication date of 1960 or later were eligible, and searches were performed within the Turning Research Into Practice database; the Cochrane Central Register of Controlled Trials; the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register; MEDLINE (Ovid); PubMed; Embase; Cumulative Index to Nursing and Allied Health Literature; and the gray literature. Study selection criteria included randomized and nonrandomized controlled trials where a single corticosteroid injection for Morton's neuroma pain was investigated. The primary outcome was Morton's neuroma pain as measured by any standard validated pain scale. Results Ten studies involving 695 participants were included. The quality of the studies was considered low and subject to bias. Of the included studies, five compared corticosteroid injection to usual care, one compared corticosteroid injection to local anesthetic alone, one compared ultrasound-guided to non–ultrasound-guided injections, three compared corticosteroid injections to surgery, one compared small to large neuromas, six assessed patient satisfaction, four measured adverse events, one studied return to work, and one examined failure of the corticosteroid injection to improve pain. Overall, these studies identified a moderate short- to medium-term benefit of corticosteroid injections on the primary outcome of pain and a low adverse event rate. Conclusions A single corticosteroid injection appears to have a beneficial short- to medium-term effect on Morton's neuroma pain. It appears superior to usual care, but its superiority to local anaesthetic alone is questionable, and it is inferior to surgical excision. A very low adverse event rate was noted throughout the studies, indicating the intervention is safe when used for Morton's neuroma. However, the quality of the evidence is low, and these findings may change with further research.

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