Background: Self-report questionnaires play an important role as outcome measures in shoulder research. Having an estimate of the measurement error of these questionnaires is of importance when assessing follow-up results after treatment and when planning intervention studies. The aim of this study was to cross-culturally adapt the Norwegian version of the OSS and WORC questionnaire and examine and compare agreement, reliability and construct validity of the diseasespecific shoulder questionnaire WORC with two commonly used shoulder questionnaires, SPADI and OSS, in patients with rotator cuff disease.

Objective To compare the effectiveness of radial extracorporeal shockwave treatment with that of supervised exercises in patients with shoulder pain. Design Single blind randomised study. Setting Outpatient clinic of physical medicine and rehabilitation department in Oslo, Norway. Participants 104 patients with subacromial shoulder pain lasting at least three months. Interventions Radial extracorporeal shockwave treatment: one session weekly for four to six weeks. Supervised exercises: two 45 minute sessions weekly for up to 12 weeks. Primary outcome measure Shoulder pain and disability index. Results A treatment effect in favour of supervised exercises at 6, 12, and 18 weeks was found. The adjusted treatment effect was −8.4 (95% confidence interval −16.5 to −0.6) points.

Objective To compare the effectiveness of ultrasound guided corticosteroid injection in the subacromial bursa with systemic corticosteroid injection in patients with rotator cuff disease.Design Double blind randomised clinical trial.Setting Outpatient clinic of a physical medicine and rehabilitation department in Oslo, Norway.Patients 106 patients with rotator cuff disease lasting at least three months.Interventions Ultrasound guided corticosteroid and lidocaine injection in the subacromial bursa and lidocaine injection in the gluteal region (local group); corticosteroid and lidocaine injection in the gluteal region and ultrasound guided lidocaine injection in the subacromial bursa (systemic group).Main outcome measures Difference in improvement in the overall shoulder pain and disability index score after six weeks.Results Six weeks after the intervention, the mean difference in improvement in overall shoulder pain and disability index score between the local group and the systemic group was −5.2 (95% confidence interval −13.9 to 3.5); it was −4.1 (−12.3 to 4.1, P=0.32) after adjustment for baseline score. A small but statistically significant difference in improvement between groups occurred in favour of the local group for two secondary outcome measures: the Western Ontario rotator cuff index (8.1, 0.7 to 15.6) and change in main complaint (2.0, 0 to 4).Conclusions No important differences in short term outcomes were found between local ultrasound guided corticosteroid injection and systemic corticosteroid injection in rotator cuff disease.Trial registration Clinical trials NCT00640575.

No significant difference was found between the SE and rESWT groups at the 1-year follow-up. More participants in the SE group had returned to work.

Background: Hydrodilatation of the glenohumeral joint is by several authors reported to improve shoulder pain and range of motion for patients with adhesive capsulitis. Procedures described often involve the injection of corticosteroids, to which the reported treatment effects may be attributed. Any important contribution arising from the hydrodilatation procedure itself remains to be demonstrated.

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BackgroundShoulder pain is common in the general population. Reports on specific diagnoses in general populations are scarce and only from primary care. The diagnostic distribution of shoulder disorders in secondary care is not reported. Most of the clinical research in the shoulder field is done in hospital settings. The aim of this study was to identify the diagnoses in a 1-year cohort in a hospital-based outpatient clinic using standardized diagnostic criteria and to compare the results with previous studies.MethodsA diagnostic routine was conducted among patients referred to our physical medicine outpatient clinic at Oslo University Hospital. Diagnostic criteria were derived from the literature and supplemented with research criteria.ResultsOf 766 patients diagnosed, 55% were women and the mean age was 49 years (range 19–93, SD ± 14). The most common diagnoses were subacromial pain (36%), myalgia (17%) and adhesive capsulitis (11%). Subacromial pain and adhesive capsulitis were most frequent in persons aged 40–60 years. Shoulder myalgia was most frequent in age groups under 40. Labral tears and instability problems (8%) were most frequent in young patients and not present after age 50. Full-thickness rotator cuff tears (8%) and glenohumeral osteoarthritis (4%) were more prevalent after the age of 60. Few differences were observed between sexes. We identified three studies reporting shoulder diagnoses in primary care.ConclusionSubacromial pain syndrome, myalgia and adhesive capsulitis were the most prevalent diagnoses in our study. However, large differences in prevalence between different studies were found, most likely arising from different use of diagnostic criteria and a difference in populations between primary and secondary care. Of the diagnoses in our cohort, 20% were not reported by the studies from primary care (glenohumeral osteoarthritis, full thickness rotator cuff tears, labral tears and instabilities).

Background: Instruments designed to measure the subjective impact of painful shoulder conditions have become essential in shoulder research. The Shoulder Pain and Disability Index (SPADI) is one of the most extensively used scales of this type. The objective of this study was to investigate reproducibility and responsiveness of the SPADI in patients with adhesive capsulitis.