Lee H-J, Lim K-B, Kim D-Y, Lee K-T. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique.
Objective:
To evaluate the clinical effect of ultrasonography (us)-guided intra-articular injections compared with a blind (unguided) technique for the treatment of adhesive capsulitis.
Design:
Randomized controlled trial.
Setting:
Outpatient rehabilitation clinic.
Participants:
Patients (n=43) diagnosed as having adhesive capsulitis after clinical examinations and radiologic and ultrasonographic study.
Intervention:
Under either us-guided or a blind technique, patients received a 20-mg intra-articular injection of triamcinolone mixed with 1.5ml 2% lidocaine and 4ml normal saline in the first week followed by 5 weekly injections of sodium hyaluronate.
Main outcome measures:
A visual analog scale for pain intensity, range of motion (rom) of the shoulder (flexion, abduction, external rotation, and internal rotation), and general shoulder function during daily activities at preinjection as a baseline and then every week after injection for 6 weeks for each patient.
Results:
Twenty patients out of 22 in the blind injection group and 20 out of 21 in the us-guided group finished the entire 6-week study period. the improvement in pain intensity, rom, and shoulder function score was significantly greater in the us-guided injection group than in the blind injection group by the second week postinjection (p<.05). however, there were no further significant differences in the improvement between the 2 groups beyond the third week.
Conclusions:
Us-guided intra-articular injections may offer advantages over a blind technique for the treatment of adhesive capsulitis and may deliver clinical benefits during the first few weeks of treatment. this finding suggests that the improved targeting to the intra-articular space by using us can result in better treatment of adhesive capsulitis.