Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis

McKean, David; Yoong, Philip; Brooks, Rebecca; Papanikitas, Joseph; Hughes, Richard J.; Pendse, Aniruddha; McElroy, Bernard John

doi:10.1007/s00256-018-3105-3

Cited by 13 publications

(12 citation statements)

References 31 publications

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“…This reduction in CHL stiffness was associated with reduced pain scores and improved Oxford Shoulder Scores. This clinical improvement is consistent with previous papers describing rotator interval injections for the treatment of adhesive capsulitis (24)(25)(26) . These findings may support the previous orthopaedic investigation that release of the CHL is associated with increased shoulder ROM (5,11,12) .…”

Section: Discussionsupporting

confidence: 92%

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

et al. 2020

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Aim of the study: To evaluate changes in the elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder treated with ultrasound-guided rotator interval injections. Methods: Shear wave elastography was used to evaluate elasticity of the coracohumeral ligament in symptomatic and asymptomatic shoulders in the shoulder-neutral position and 30° external rotation. A total of 24 shoulders were assessed. Symptomatic shoulders were treated with targeted steroid injection via the rotator interval and manipulation under local anaesthetic block. Follow-up assessment of the elasticity of the coracohumeral ligament was obtained at 10 weeks post-injection. Results: In all subjects, the coracohumeral ligament elastic modulus was larger at 30° external rotation than in the neutral position. In patients with adhesive capsulitis, the coracohumeral ligament thickness and elastic modulus was significantly greater in the symptomatic shoulder in the neutral position and 30° ER. Treated patients had an excellent response with improved Oxford Shoulder Score and reduced visual analogue scale pain scores. Median Oxford Shoulder Score was 13.5 pre-injection and 34 at 10 weeks postinjection. Median visual analogue scale pain scores measured 8.5 pre-injection, 3.5 at 1 day, 2 at 1 week, and 2.5 at 10 weeks. Improved Oxford Shoulder Score and visual analogue scale pain score was associated with a trend to normalisation of the elastic modus of the coracohumeral ligament. Conclusion: In patients with adhesive capsulitis of the shoulder, shear wave elastography demonstrated the coracohumeral ligament is stiffer in the symptomatic shoulder than in the unaffected shoulder. Treatment with the ultrasound-guided rotator interval injection is associated with improved Oxford Shoulder Score, reduced visual analogue scale pain scores, and reduced stiffness in the coracohumeral ligament.

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Section: Discussionsupporting

confidence: 92%

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

et al. 2020

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“…Ultrasound-guided injection of the RI is an established technique for hydrodilatation, intra-articular injection, and arthrograms (1)(2)(3) . The procedure is performed via a lateral to medial approach.…”

Section: Discussionmentioning

confidence: 99%

“…3). There is marked thickening of the CHL in adhesive capsulitis with associated synovitis in the RI (1) . interval.…”

Section: Anatomymentioning

confidence: 95%

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Ultrasound guided injection of the rotator interval – Gaurav-Botchu technique

Sharma

Botchu

2021

J Ultrason

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Ultrasound-guided injection of the shoulder via the rotator interval can be challenging. The procedure is used for arthrograms, hydrodilatation and intra-articular glenohumeral joint injections. The conventional approach to the rotator interval is from lateral to medial. However, the placement of the needle in the target zone i.e. between the coracohumeral ligament and the long head of the biceps, can be difficult and challenging. Inadvertent injection performed with the needle in the long head of the biceps tendon can result in a biceps tendon rupture. We describe a new method (Gaurav-Botchu technique) to access the target zone (between the coracohumeral ligament and the long head of the biceps tendon) via a medial to lateral approach, which increases the target zone.

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“…Thereafter, the drainage effect was evaluated, and the drainage was continued for 2 -4 more weeks if necessary, during which their drainage tubes and changes in condition were observed. Patients were extubated when the drainage fluid became much clearer and the amylase index was normal [9][10][11]. After extubation, the patients were observed for recurrence of disease.…”

Section: Treatmentsmentioning

confidence: 99%

Combined effect of ultrasound-guided percutaneous abdominal paracentesis drainage and ulinastatin on severe acute pancreatitis

Liu¹,

Yuan²,

Wang³

et al. 2021

Trop. J. Pharm Res

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Purpose: To study the clinical effect of a combination of ultrasound-guided percutaneous abdominal paracentesis drainage (APD) and ulinastatin on severe acute pancreatitis (AP).Methods: A total of 94 patients with severe AP in Intensive Care Unit, Jiaozhou Central Hospital, Qingdao, from December 2017 to December 2018 were selected as the research subjects. They were divided into control and study groups, with 47 patients in each group. Patients in the control group underwent laparotomy drainage, while patients in the study group underwent ultrasound-guidedpercutaneous APD. Patients in both groups received ulinastatin perfusion. Subsequently, clinical effectsand other relevant indicators were determined.Results: Overall response was significantly higher in the study group than in the control group (p < 0.05). The times taken for disappearance of postoperative symptoms, normalization of serum amylase level, and hospitalization were significantly shorter in the study group than in the control group (p < 0.05). For every indicator, the study group exhibited more benefits after than before treatment; however, post-treatment levels of blood glucose, hemodiastase and urinary amylase were better than those in the control group (p < 0.05). Incidence of postoperative complications was lower in the study group than in control group (p < 0.05).Conclusion: The combination of ultrasound-guided percutaneous APD with ulinastatin produces marked beneficial effects on severe AP patients. It facilitates the remission of adverse symptoms, and enhances normalization of indicator levels. Moreover, it displays low incidence of complications, better prognosis and recovery, and absence of post-operation infections.

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Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis

Cited by 13 publications

References 31 publications

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

Ultrasound guided injection of the rotator interval – Gaurav-Botchu technique

Combined effect of ultrasound-guided percutaneous abdominal paracentesis drainage and ulinastatin on severe acute pancreatitis

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