Comparison of Clinical Outcomes between Idiopathic Frozen Shoulder and Diabetic Frozen Shoulder After a Single Ultrasound-Guided Intra-Articular Corticosteroid Injection.

Chul-Hyun Cho,Du Hwan Kim,Hyo-Joon Jin

doi:10.3390/diagnostics10060370

Abstract

There is no consensus on the use of intra-articular corticosteroid injections in diabetic frozen shoulder (FS). Thus, we aimed to compare clinical outcomes after intra-articular corticosteroid injections in patients with diabetic FS and idiopathic FS. Data collected from 142 FS patients who received glenohumeral joint intra-articular corticosteroid injections were retrospectively reviewed. Thirty-two patients were diagnosed with diabetic FS and 110 patients with idiopathic FS. Data including visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and passive range of motion (ROM) were compared before the injection and at 3, 6, and 12 weeks after the injection. There were significant improvements in all outcomes (p < 0.001 for all parameters) through 12 weeks in both groups. There were no significant differences in all outcomes, except for ASES scores, between both groups at 3 weeks. However, there were significant differences in VAS score, SSVs, ASES scores, and passive ROMs, except for angle of abduction, between the two groups at 6 weeks and 12 weeks after injection. A single intra-articular steroid injection can be used as a conservative treatment for diabetic FS, but less effective than for idiopathic FS.

Highlights

Frozen shoulder (FS) is a common shoulder disorder characterized by progressive painful stiffness of the glenohumeral joint that is caused by an inflammatory contracture of the capsule [1,2]
There were no significant differences in age, the involvement of dominance side, duration of symptoms and clinical scores between the two groups (Table 1)
Seven patients complained of temporary facial flushing, and two patients complained of skin itching sensation. This present study revealed that intra-articular corticosteroid injection led to significant improvements in pain severity, functional scores, and range of motion (ROM) through 12 weeks in both diabetic and non-diabetic FS patients

Summary

Introduction

Frozen shoulder (FS) is a common shoulder disorder characterized by progressive painful stiffness of the glenohumeral joint that is caused by an inflammatory contracture of the capsule [1,2]. FS usually develops without any trauma or specific shoulder disease [3]. If the cause of the painful stiff shoulder is unknown, “idiopathic FS” is considered. The exact pathogenesis of FS is unknown, the risk factors include female sex, diabetes, thyroid disease, and hypercholesterolemia [4,5,6,7,8]. Diabetes is suggested to be one of the strongest factors for the development of FS. If patients with a painful stiff shoulder are diagnosed with diabetes, the term “diabetic FS” is commonly used [8,9,10].

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