Advanced SearchSearch Tips
A Randomized Comparative Study of Blind versus Ultrasound Guided Glenohumeral Joint Injection of Corticosteroids for Treatment of Shoulder Stiffness
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
  • Journal title : Clinics in Shoulder and Elbow
  • Volume 18, Issue 3,  2015, pp.120-127
  • Publisher : Korean Shoulder and Elbow Society
  • DOI : 10.5397/cise.2015.18.3.120
 Title & Authors
A Randomized Comparative Study of Blind versus Ultrasound Guided Glenohumeral Joint Injection of Corticosteroids for Treatment of Shoulder Stiffness
Lee, Hyo-Jin; Ok, Ji-Hoon; Park, In; Bae, Sung-Ho; Kim, Sung-Eun; Shin, Dong-Jin; Kim, Yang-Soo;
  PDF(new window)
Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Shoulder stiffness;Glenohumeral joint injection;Corticosteroid;Ultrasound-guided injection;
 Cited by
Hannafin JA, Chiaia TA. Adhesive capsulitis. A treatment approach. Clin Orthop Relat Res. 2000;(372):95-109.

van der Windt DA, Koes BW, Devillé W, Boeke AJ, de Jong BA, Bouter LM. Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial. BMJ. 1998;317(7168):1292-6. crossref(new window)

Bal A, Eksioglu E, Gulec B, Aydog E, Gurcay E, Cakci A. Effectiveness of corticosteroid injection in adhesive capsulitis. Clin Rehabil. 2008;22(6):503-12. crossref(new window)

Cicak N, Matasovic T, Bajraktarevic T. Ultrasonographic guidance of needle placement for shoulder arthrography. J Ultrasound Med. 1992;11(4):135-7.

Valls R, Melloni P. Sonographic guidance of needle position for MR arthrography of the shoulder. AJR Am J Roentgenol. 1997; 169(3):845-7. crossref(new window)

Farmer KD, Hughes PM. MR arthrography of the shoulder: fluoroscopically guided technique using a posterior approach. AJR Am J Roentgenol. 2002;178(2):433-4. crossref(new window)

Jacobson JA, Lin J, Jamadar DA, Hayes CW. Aids to successful shoulder arthrography performed with a fluoroscopically guided anterior approach. Radiographics. 2003;23(2):373-8. crossref(new window)

Rutten MJ, Collins JM, Maresch BJ, et al. Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography. Eur Radiol. 2009;19(3):722-30. crossref(new window)

Porat S, Leupold JA, Burnett KR, Nottage WM. Reliability of non-imaging-guided glenohumeral joint injection through rotator interval approach in patients undergoing diagnostic MR arthrography. AJR Am J Roentgenol. 2008;191(3):W96-9. crossref(new window)

Patel DN, Nayyar S, Hasan S, Khatib O, Sidash S, Jazrawi LM. Comparison of ultrasound-guided versus blind glenohumeral injections: a cadaveric study. J Shoulder Elbow Surg. 2012; 21(12):1664-8. crossref(new window)

Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3(6):347-52. crossref(new window)

Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP. Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg. 2011;20(7):1034-40. crossref(new window)

Farrar JT, Pritchett YL, Robinson M, Prakash A, Chappell A. The clinical importance of changes in the 0 to 10 numeric rating scale for worst, least, and average pain intensity: analyses of data from clinical trials of duloxetine in pain disorders. J Pain. 2010;11(2):109-18. crossref(new window)

Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149-58. crossref(new window)

Lee HJ, Lim KB, Kim DY, Lee KT. Randomized controlled trial for efficacy of intra-articular injection for adhesive capsulitis: ultrasonography-guided versus blind technique. Arch Phys Med Rehabil. 2009;90(12):1997-2002. crossref(new window)

Rutten MJ, Maresch BJ, Jager GJ, de Waal Malefijt MC. Injection of the subacromial-subdeltoid bursa: blind or ultrasoundguided? Acta Orthop. 2007;78(2):254-7. crossref(new window)

Catalano OA, Manfredi R, Vanzulli A, et al. MR arthrography of the glenohumeral joint: modified posterior approach without imaging guidance. Radiology. 2007;242(2):550-4. crossref(new window)

Daley EL, Bajaj S, Bisson LJ, Cole BJ. Improving injection accuracy of the elbow, knee, and shoulder: does injection site and imaging make a difference? A systematic review. Am J Sports Med. 2011;39(3):656-62. crossref(new window)