Effect of Ultrasound-guided Hyaluronic or Corticosteroid Injections in Patients With Chronic Subacromial Bursitis

Launched by SHIN KONG WU HO-SU MEMORIAL HOSPITAL · Mar 2, 2016

Keywords

ClinConnect Summary

Chronic subacromial bursitis (SAB) is a common shoulder disorder characterized by chronic shoulder pain with a painful arc of motion, which commonly occurs during abduction and sometimes during internal rotation of the shoulder. In addition, the extremes of all passive movements are painful. The range of motion (ROM) of the shoulder is usually not limited or is limited in a non-capsular pattern (mainly abduction and internal rotation). All resisted movements are painless or equally painful, and there is also tenderness over the deltoid region. The diagnosis of SAB remains doubtful until it ...

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Eligibility criteria

• Inclusion Criteria:
• • 1. shoulder pain for more than 1 month
• • 2. age ≥ 20 years old
• • 3. painful abduction or internal rotation with a visual analog scale (VAS) pain score ≥4
• • 4. the presence of a painful arc of motion or pain at the middle to terminal range of shoulder abduction or internal rotation with a soft end feel
• • 5. tenderness over the subacromial bursa
• • 6. a reduction in pain of ≥40% on active shoulder abduction or internal rotation at the terminal range after injection of 3ml of 1%lidocain into the SASD bursa under ultrasound (US) guidance.
• Exclusion Criteria:
• • 1. a history of uncontrolled chronic diseases, e.g., malignant neoplasms, blood dyscrasia, and infection
• • 2. previous surgery of the affected shoulder
• • 3. any evidence of a rotator cuff tear or tendinopathy, demonstrated by positive resistive tests or sonographic findings
• • 4. calcification of the rotator cuff, demonstrated by x-ray or sonographic findings
• • 5. the presence of arthritis, such as inflammatory arthritis (e.g., rheumatoid arthritis, seronegative spondyloarthropathy, or crystal-related arthropathy), osteoarthritis, frozen shoulder, subacromial spurs, or deformity of the acromion
• • 6. the presence of instability of the affected shoulder
• • 7. a previous fracture near the shoulder region
• • 8. the presence of cervical radiculopathy or myelopathy
• • 9. having received a corticosteroid or hyaluronic acid subacromial or shoulder joint injection in the past 3 months