Relationship between subacromial bursitis on ultrasonography and efficacy of subacromial corticosteroid injection in rotator cuff disease: a prospective comparison study

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Doo-Hyung Lee, Ji Yeon Hong, Michael Young Lee, Kyu-Sung Kwack, Seung-Hyun Yoon
ObjectiveTo evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in rotator cuff disease patients.DesignProspective, longitudinal comparison study.SettingUniversity-affiliated tertiary care hospital.ParticipantsPatients with rotator cuff disease (N=69) were classified into three groups based on ultrasonographic findings; (1) normal bursa group (group 1, n=23): bursa and effusion thickness <1 mm, (2) bursa thickening group (group 2, n=22): bursa thickness >2 mm and effusion thickness <1 mm, (3) bursa effusion group (group 3, n=24): bursa thickness <1 mm and effusion thickness >2 mm.InterventionA single subacromial injection with 20 mg of triamcinolone acetonide.Main Outcome Measures: Visual analog scale (VAS) of the shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre-treatment and post-treatment at week 8.ResultsThere were no significant differences between the 3 groups in demographic characteristics pre-treatment. Groups 2 and 3 showed a significant difference compared to group 1 in changes of VAS and abduction; group 3 showed a significant difference compared to group 1 in changes of SDQ, internal rotation and external rotation; and all groups showed significant differences when compared to each other (1 and 3, 2 and 3, and 1 and 2) in changes of thickness.ConclusionA patient with ultrasonographic observation of subacromial bursitis, instead of normal bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection.



http://ift.tt/2iCFEyK