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Targeted ultrasound-guided hydrodilatation via the rotator interval for adhesive capsulitis

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Abstract

Objective

To describe and evaluate ultrasound-guided hydrodilatation via the rotator interval for the treatment of adhesive capsulitis.

Materials and methods

Patients referred to our department with adhesive capsulitis were consented for hydrodilatation. Inclusion criteria included a failure to respond to conservative treatment and the absence of full thickness rotator cuff tear. Twenty-one milliliters of a mixture of local anesthetic and steroid was injected into the rotator interval using a 21-gauge needle. Patients were followed up at 2 weeks and 4 months, with documented pain scores from 0 to 10 on a visual analogue scale and the Oxford Shoulder Questionnaire.

Results

Twenty-two patients were suitable for inclusion in the study. Nineteen were female (86 %) and three were male. The mean age was 55 years (range, 32–71 years). The duration of symptoms ranged from 4 weeks to 20 months. At 4 months, 19/22 (86 %) of patients described either complete (7/22) or good (12/22) improvement in their symptoms. The mean pain score was 8.4 prior to the procedure, 3.1 at 48 h and 1.9 at 4 months, and 20/22 (91 %) had a lower pain score after 4 months. There was a statistically significant (p < 0.05) improvement in the Oxford shoulder score, from a mean of 13.6 pre-procedure to 36.5 at 4 months.

Conclusions

The rotator interval and anterior joint capsule are strongly implicated in the symptomatology of adhesive capsulitis. The novel use of targeted ultrasound-guided hydrodilatation via the rotator interval gives good results in reducing shoulder pain and symptoms in adhesive capsulitis.

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Conflict of interest

The authors report no conflicts of interest associated with this study.

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Authors and Affiliations

  1. Department of Radiology, Royal Berkshire Hospital, Reading, UK

    Philip Yoong

  2. Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK

    Stephen Duffy & Nabil P. Hujairi

  3. Department of Radiology, Nuffield Orthopaedic Centre, Oxford, UK

    David McKean, Ramy Mansour & James L. Teh

Authors
  1. Philip Yoong
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  2. Stephen Duffy
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  3. David McKean
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  4. Nabil P. Hujairi
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  5. Ramy Mansour
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  6. James L. Teh
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Correspondence to Philip Yoong.

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Yoong, P., Duffy, S., McKean, D. et al. Targeted ultrasound-guided hydrodilatation via the rotator interval for adhesive capsulitis. Skeletal Radiol 44, 703–708 (2015). https://doi.org/10.1007/s00256-014-2047-7

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  • DOI: https://doi.org/10.1007/s00256-014-2047-7

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