Ultrasound guided glenohumeral injections in adhesive capsulitis

Abstract

Objective: The objective of this thesis was to assess outcomes of glenohumeral corticosteroid injections for adhesive capsulitis. Design: The thesis was composed of two parts. First, a systematic literature review was conducted on glenohumeral corticosteroid injections on shoulder outcomes for adhesive capsulitis. Second, an original prospective study was conducted to measure the effect of ultrasound-guided injections on pain and function for adhesive capsulitis patients. Setting: All injections for the prospective injection study were conducted at Brigham and Women’s Hospital in Boston, MA. Patients: Inclusion criteria were patients receiving an ultrasound guided injection for adhesive capsulitis. 67 patients were included, 59 patients were available at first follow up, and 40 patients were available at final follow up. Methods: The literature review was conducted using the online databases PubMed (1966-present), Embase (1947-present), Web of Science (1900– present), and the Cochrane Central Register of Controlled Trials. Study criteria were limited to clinical trials that evaluated the application of corticosteroid injections, both alone and in combination with other treatment modalities, specifically for the condition of adhesive capsulitis in the shoulder. Studies involving non-corticosteroid injections or injections for conditions not specific to adhesive capsulitis were excluded. Results were limited to papers in the English language. A data table summarizing pain, function, and range of motion outcomes of each treatment was produced. A percent change from baseline was calculated to facilitate comparisons. For the injection study, the first follow-up took place after an average of 2.0 months and patients' improvement in pain and range of motion were assessed. During a final follow-up after an average of 10.4 months, patients’ pain and shoulder function scores were assessed over telephone. [TRUNCATED]