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A prospective study of 100 patients with rotator cuff tendinopathy showed no correlation between subacromial bursitis and the efficacy of ultrasound-guided corticosteroid injection

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Abstract

Objectives

The objective of this study was to determine whether the presence of subacromial bursitis in patients with rotator cuff tendinopathy (RCT) was associated with a better outcome after ultrasound (US)-guided subacromial corticosteroid injection.

Methods

A single-center prospective study was performed including patients referred for subacromial injection to manage RCT. At baseline, all patients received an US-guided intra-bursal injection of betamethasone (1 ml). The primary endpoint was reduced pain 3 months (M3) after the procedure: a good responder was defined by a decrease in Visual Analogue Scale pain of more than 30%. Secondary endpoints included functional recovery assessed by the Oxford Shoulder Score (OSS) and clinical success at 6 weeks (W6). We also explored the association between good clinical response and other factors, such as US or X-ray features.

Results

One hundred patients were included and 49 presented with subacromial bursitis. At M3, 60% of patients (54/100) were considered good responders. The rate of good responders did not differ between the bursitis and non-bursitis groups (p = 0.6). During follow-up, OSS improved over time whether bursitis was present or not. We did not find any US or X-ray features significantly associated with a favorable clinical outcome.

Conclusion

The presence of subacromial bursitis did not influence clinical outcomes at 3 months post-subacromial injection in patients suffering from RCT.

Clinical relevance statement

The presence of subacromial bursitis did not influence clinical outcomes at 3 months post-subacromial corticosteroid injection in patients with rotator cuff tendinopathy. For patient management, looking for ultrasonographic signs of bursitis does not appear relevant for the indication of the injection.

Key points

• Ultrasound-guided subacromial corticosteroid injections led to a significant improvement in 60% of patients suffering from rotator cuff tendinopathy.

• The presence of subacromial bursitis was not associated with better improvement at 3 months post-injection.

• Except for the Minnesota score referring to job satisfaction, we did not find any baseline clinical, X-ray, or ultrasound characteristics associated with a successful outcome.

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Abbreviations

ACJ:

Acromio-clavicular joint

CSA:

Critical shoulder angle

MCID:

Mean clinical important difference

NSAIDs:

Non-steroidal anti-inflammatory drugs

OSS:

Oxford Shoulder Score

RCT:

Rotator cuff tendinopathy

US:

Ultrasound

VAS:

Visual Analogue Scale

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Acknowledgements

We acknowledge Mrs. Aurélie Le Thuaut for her help with the statistics.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Service de Rhumatologie, CH de Cholet, Cholet, France

    Benoit Metayer

  2. Service de Rhumatologie, CHU Nantes, 1 Place Alexis Ricordeau, 44000, Nantes, France

    Benoit Metayer, Benoit Le Goff & Christelle Darrieutort-Laffite

  3. Service de Médecine Physique Et Réadaptation Locomotrice Et Respiratoire, CHU Nantes, Nantes, France

    Alban Fouasson-Chailloux

  4. Nantes Université, Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000, Nantes, France

    Alban Fouasson-Chailloux, Benoit Le Goff & Christelle Darrieutort-Laffite

Authors
  1. Benoit Metayer
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  2. Alban Fouasson-Chailloux
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  3. Benoit Le Goff
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  4. Christelle Darrieutort-Laffite
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Corresponding author

Correspondence to Christelle Darrieutort-Laffite.

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Guarantor

The scientific guarantor of this publication is Christelle Darrieutort-Laffite.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Aurélie Le Thuaut kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained for all patients.

Ethical approval

Institutional Review Board approval was obtained. The protocol was approved by a local ethics committee.

Study subjects or cohorts overlap

None.

Methodology

• Prospective

• Observational

• Performed at one institution

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Metayer, B., Fouasson-Chailloux, A., Le Goff, B. et al. A prospective study of 100 patients with rotator cuff tendinopathy showed no correlation between subacromial bursitis and the efficacy of ultrasound-guided corticosteroid injection. Eur Radiol 34, 300–307 (2024). https://doi.org/10.1007/s00330-023-09989-z

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  • DOI: https://doi.org/10.1007/s00330-023-09989-z

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