Effectiveness of USG-guided corticosteroid injection administered into the glenohumeral joint and oral prednisone treatment in patients with adhesive capsulitis

Abstract

Objective: This study aims to compare the efficacy of ultrasonography-guided corticosteroid injection to the glenohumeral joint and oral steroid therapy on clinical response and inferior axillary pouch (AR) thickness measured by ultrasonography (USG) in patients with adhesive capsulitis (AC). Methods: Our prospective randomized study included 48 patients (18-65 years) with a diagnosis of AC. The first group (n=24) underwent USG-guided corticosteroid injection to glenohumeral joint. In the second group (n=24), oral prednisone was started at 0.5 mg/kg dose with the dosing schedule determined by decreasing and continued for 6 weeks. Both groups were also included in a standard physical therapy program (electrotherapy + exercises). The questionnaire, active and passive shoulder joint ROM measurements, Shoulder Pain and Disability Index, evaluation of the joint with USG, and AR thickness measurements were performed. Results: There was a statistically significant increase in passive-active ROM values in all directions before and after the treatment (p<0.05) and decrease in AR values after the treatment (p<0.001) in both groups. However, there was no significant difference between the two groups. In addition, the decrease in inferior pouch thickness and the decrease in SPADI scores were positively correlated. Conclusion: Steroid injection into the glenohumeral joint and oral steroid use significantly reduced shoulder pain and disability and increased range of motion in AC patients. Moreover, both oral steroid and steroid injection treatments improved radiologic findings (by reducing AR), consistent with clinical response. Although both treatments were effective, they were not superior to each other.