Wednesday, May 29, 2019

Ultrasound-Guided Standard versus Dual-Target Subacromial Corticosteroid Injections for Shoulder Impingement Syndrome: A Randomized Controlled Trial

Publication date: Available online 29 May 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Jia-Chi Wang, Ke-Vin Chang, Wei-Ting Wu, Der-Sheng Han, Levent Özçakar

Abstract
Objective

To compare dual-target injection with standard US-guided subacromial injection in patients with SIS and possible disorders of the biceps long-head tendons.

Design

Double-blind, randomized controlled trial.

Setting

Rehabilitation outpatient clinic.

Participants

Patients with SIS (N=60).

Intervention

(1) US-guided standard subacromial bursa and (2) dual-target (subacromial bursa plus proximal biceps long-head tendon) injection, with 40-mg triamcinolone acetonide administered to patients in each group.

Main Outcome Measures

Clinical assessments were performed at baseline. The outcomes, including results from a self-administered questionnaire, the Shoulder Pain and Disability Index (SPADI), and a self-pain report, the visual analogue scale (VAS) scores for pain at rest, at night, and during overhead activities, were evaluated at baseline and at the first and third months post-intervention.

Results

No significant difference was observed in baseline evaluations between groups (n = 30 in each treatment arm) prior to injections. Both groups exhibited significant SPADI and VAS-score improvements after the first month. The dual-target injection group had less rebounding pain at the 3-month follow-up. The standard injection group had more patients reporting worsening pain within 1 day post-injection.

Conclusion

US-guided dual-target corticosteroid injection showed similar short-term efficacy to standard subacromial injections, but with an extended duration of symptom relief. Therefore, dual-target corticosteroid injections may be useful for shoulder-pain treatment in patients with SIS.



from ScienceDirect Publication: Archives of Physical Medicine and Rehabilitation http://bit.ly/2EEaf8c
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