Intra-articular distension and steroids in the management of capsulitis of the shoulder.
نویسندگان
چکیده
OBJECTIVE To determine whether there is any synergistic effect in the administration of intraarticular steroids with distension in the management of early capsulitis of the shoulder. DESIGN Prospective randomised trial of three treatments--namely distension only, steroid only, and steroid with distension. SETTING Academic department of orthopaedic and accident surgery at Queen's Medical Centre, Nottingham. SUBJECTS 47 patients (30 women) with capsulitis affecting 50 shoulders. INTERVENTIONS Three intra-articular injections into the shoulder given at six week intervals by the same technique. MAIN OUTCOME MEASURES Passive range of abduction, forward flexion, and external rotation; results of shoulder dynamometry measuring work done and torque produced; pain levels at rest and with resisted movement. RESULTS All patients reported improvement during the study. Analysis of the mean improvements in abduction and forward flexion showed these to be significantly greater in the steroid with distension and steroid only groups than in the distension only group (mean improvements in abduction (degrees/week (95% confidence interval)) 4.3 (3.4 to 5.2), 3.4 (2.4 to 4.5), and 1.0 (-0.8 to 2.8) in the three groups respectively; mean improvements in flexion (degrees/week (95% confidence interval)) 3.6 (3.2 to 4.0), 3.3 (2.3 to 4.3), and 1.5 (0.5 to 2.5) respectively). Shoulder dynamometry failed to show a significant difference among the treatment groups. No severe complications occurred as a result of the injections, but two patients reported facial flushing related to the use of steroids. CONCLUSION Intra-articular steroid injections have a useful role in the outpatient management of early capsulitis.
منابع مشابه
Multi-modal imaging of adhesive capsulitis of the shoulder
UNLABELLED Adhesive capsulitis of the shoulder is a clinical condition characterized by progressive limitation of active and passive mobility of the glenohumeral joint, generally associated with high levels of pain. Although the diagnosis of adhesive capsulitis is based mainly on clinical examination, different imaging modalities including arthrography, ultrasound, magnetic resonance, and magne...
متن کاملAdhesive capsulitis of the shoulder, treatment with corticosteroid, corticosteroid with distension or treatment-as-usual; a randomised controlled trial in primary care.
BACKGROUND Optimal management for adhesive shoulder capsulitis (frozen shoulder) is currently unclear. We intended to explore whether treatment by intra-articular injections with corticosteroid and distension is more effective than treating with corticosteroids alone or treatment-as-usual in a primary care setting in Norway. METHODS In this prospective randomised intention to treat parallel s...
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ورودعنوان ژورنال:
- BMJ
دوره 302 6791 شماره
صفحات -
تاریخ انتشار 1991