Subacromial ultrasound guided or systemic steroid injection for rotator cuff disease: randomised double blind study

Ekeberg, Ole Marius; Bautz‐Holter, Erik; Tveitå, Einar Kristian; Juel, Niels Gunnar; Kvalheim, Synnøve; Brox, Jens Ivar

doi:10.1136/bmj.a3112

Cited by 141 publications

(102 citation statements)

References 44 publications

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“…24 Apart from a benefi cial effect on GTPS, in our patients with comorbidity, the injections might also have had a benefi cial effect on osteoarthritis or low-back pain.…”

Section: Discussionmentioning

confidence: 99%

Corticosteroid Injections for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial in Primary Care

Brinks

Rijn²,

Willemsen³

et al. 2011

The Annals of Family Medicine

112

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PURPOSE We undertook a study to evaluate the effectiveness of corticosteroid injections in primary care patients with greater trochanteric pain syndrome (GTPS). METHODSWe evaluated the effect of corticosteroid injections compared with expectant treatment (usual care) in a pragmatic, multicenter, open-label, randomized clinical trial in the Netherlands. Patients (aged 18 to 80 years) with GTPS visiting 81 participating primary care physicians were randomly allocated to receive either local corticosteroid injections (n = 60) or usual care (n = 60). Primary outcomes of pain severity (numerical rating scale 0 to 10) and recovery (yes or no total or major recovery) were evaluated at 3-month and 12-month follow-up visits. Adverse events were collected at 6 weeks.RESULTS At the 3-month follow-up visit, 34% of the patients in the usual care group had recovered compared with 55% in the injection group (adjusted OR = 2.38; 95% CI, 1.14-5.00, number needed to treat = 5). Pain severity at rest and on activity decreased in both groups, but the decrease was greater in the injection group, for an adjusted difference in pain at rest of 1.18 (95% CI, 0.31-2.05) and in pain with activity of 1.30 (95% CI, 0.32-2.29). At the 12-month follow-up, 60% of the patients in the usual care group had recovered compared with 61% in the injection group (OR = 1.05; 95% CI, 0.50-2.27). Pain severity at rest and on activity decreased in both groups and the 12-month follow-up showed no signifi cant differences, with adjusted differences of 0.14 (95% CI, -0.75 to 1.04) for pain at rest and 0.45 (95% CI, -0.55 to 1.46) for pain with activity. Aside from a short period with superfi cial pain at the site of the injection, no differences in adverse events were found. CONCLUSION In this fi rst randomized controlled trial assessing the effectiveness of corticosteroid injections vs usual care in GTPS, a clinically relevant effect was shown at a 3-month follow-up visit for recovery and for pain at rest and with activity. At a 12-month follow-up visit, the differences in outcome were no longer present.

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“…24 Apart from a benefi cial effect on GTPS, in our patients with comorbidity, the injections might also have had a benefi cial effect on osteoarthritis or low-back pain.…”

Section: Discussionmentioning

confidence: 99%

Corticosteroid Injections for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial in Primary Care

Brinks

Rijn²,

Willemsen³

et al. 2011

The Annals of Family Medicine

112

View full text Add to dashboard Cite

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“…However, the impact on therapeutic effect is controversial. A randomised double-blind trial demonstrated evidence that intramuscular steroid is as effective as intrabursal steroid in patients with subacromial impingement [6]. However, both groups in this study received intrabursal lignocaine, which itself may have a therapeutic effect.…”

Section: Image Guidancementioning

confidence: 64%

Radiological interventions for soft tissue injuries in sport

Campbell

Dunn²

2012

The British Journal of Radiology

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ABSTRACT. Injection therapy has played an integral role in the rehabilitation of sports injuries for many years. The athlete's primary goal is a rapid return to sporting activity. This may be achieved by a combination of either a temporary or permanent reduction in pain, and by a pharmacological or physiological effect that promotes or accelerates a healing response. A wide variety of pharmacological agents are used. However, there is often a lack of good evidence that quantifiable effects can be achieved. There are restrictions on the use of some pharmaceutical agents. This article reviews the various pharmacological agents and bioactive substrates that are available, and discusses the current evidence base of their use in common sports injuries.

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“…Nevertheless, some have suggested that ultrasound guidance does not make a difference in long-term efficacy [29,30]. The results of one study indicate that local corticosteroid injection with guided ultrasound is no more effective than systemic corticosteroid injection for short-term improvement in rotator cuff disease [31]. Harmon and O'Connor [32] argue that injections may not need accurate ultrasound-guided placement, particularly with corticosteroid, which may diffuse through the tissue planes to affect the target tissue despite inaccuracy.…”

Section: Ultrasound-guided Injectionsmentioning

confidence: 99%

A physiotherapy perspective of musculoskeletal imaging in sport

Callaghan

2012

The British Journal of Radiology

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ABSTRACT. This paper presents a physiotherapy perspective on the role that imaging is now playing in the diagnosis and management of musculoskeletal and sporting injuries. Although the Royal College of Radiologists and the UK Chartered Society of Physiotherapy were founded in the latter part of the nineteenth century, it is 100 years later that developments in the UK NHS have led to increased roles for non-medical healthcare professionals and allied health professionals, such as physiotherapists, in an extended clinical role. Physiotherapists, perhaps because of their knowledge of clinical and applied anatomy, have keenly taken up the opportunities offered to request and interpret imaging in its various forms; the most commonly available are plain radiography, musculoskeletal ultrasound and MRI. This has meant taking formal courses under the auspices of universities with mentorship and tutoring within the clinical setting, which are part of a continuing professional development. The ability to request several forms of imaging has enhanced physiotherapy practice and has increased the appreciation of the responsibilities which accompany this new role.

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Subacromial ultrasound guided or systemic steroid injection for rotator cuff disease: randomised double blind study

Cited by 141 publications

References 44 publications

Corticosteroid Injections for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial in Primary Care

Corticosteroid Injections for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial in Primary Care

Radiological interventions for soft tissue injuries in sport

A physiotherapy perspective of musculoskeletal imaging in sport

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