• Hong-Jae Lee, Kil-Byung Lim, Dug-Young Kim, and Kyung-Tae Lee.
• Department of Rehabilitation Medicine, Ilsan-Paik Hospital, Inje University, and Institute of Sports Rehabilitation, Inje University, Goyang city, Gyonggi-do, South Korea. honglee@paik.ac.kr
• Arch Phys Med Rehabil. 2009 Dec 1;90(12):1997-2002.

UnlabelledLee 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.ObjectiveTo evaluate the clinical effect of ultrasonography (US)-guided intra-articular injections compared with a blind (unguided) technique for the treatment of adhesive capsulitis.DesignRandomized controlled trial.SettingOutpatient rehabilitation clinic.ParticipantsPatients (N=43) diagnosed as having adhesive capsulitis after clinical examinations and radiologic and ultrasonographic study.InterventionUnder 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 MeasuresA 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.ResultsTwenty 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.ConclusionsUS-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.

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