Comparison of Sono-guided Capsular Distension with Fluoroscopically Capsular Distension in Adhesive Capsulitis of Shoulder

Objective To investigate the short-term effects and advantages of sono-guided capsular distension, compared with fl uoroscopically guided capsular distension in adhesive capsulitis of shoulder. Method In this prospective, randomized, and controlled trial, 23 patients (group A) were given an intra-articular injection of a mixture of 0.5% lidocaine (9 ml), contrast dye (10 ml), and triamcinolone (20 mg); they received the injection once every 2 weeks, for a total of 6 weeks, under sono-guidance. Twenty-five patients (group B)were treated similarly, under fl uoroscopic guidance. Instructions for the self-exercise program were given to all subjects, without physiotherapy and medication. Eff ects were then assessed using a visual numeric scale (VNS),and the shoulder pain and disability index (SPADI), as well as a range of shoulder motion examinations which took place at the beginning of the study and 2 and 6 weeks after the last injection. Incremental cost-eff ective ratio (ICER), eff ectiveness, preference, and procedure duration were evaluated 6 weeks post-injection. Results The VNS, SPADI, and shoulder motion range improved 2 weeks after the last injection and continued to improve until 6 weeks, in both groups. However, no statistical differences in changes of VNS, SPADI, ROM, and eff ectiveness were found between these groups. Patients preferred sono-guided capsular distension to fl uoroscopically guided capsular distension due to diff erences in radiation hazards and positional convenience. Procedure time was shorter for sono-guided capsular distension than for fl uoroscopically guided capsular distension. Conclusion Sono-guided capsular distension has comparable effects with fluoroscopically guided capsular distension for treatment of adhesive capsulitis of the shoulder. Sono-guided capsular distension can be substituted for fl uoroscopic capsular distension and can be advantageous from the viewpoint of radiation hazard mitigation,time, cost-eff ectiveness and convenience.