Aims and objectives
Adhesive capsulitis of the shoulder is a condition of unknown etiology that results in the restriction of active and passive glenohumeral motion.
It is a relatively common condition with a 2-5% prevalence in the population.
Risk factors include age,
diabetes,
trauma and thyroid disease (1).
Initial treatment involves analgesia and physiotherapy,
however if these are not effective then referral to secondary care is indicated.
Options then include manipulation under anaesthesia,
surgical arthroscopic rupture and fluoroscopic shoulder hydrodilatation (2).
A retrospective audit was conducted assessing the...
Methods and materials
A retrospective search of the radiological information system (CRIS,
Healthcare Software Systems,
UK) was carried out for fluoroscopic shoulder hydrodilatation procedures done at Aintree University hospital between 01/01/2017 to 31/12/2017.
Patient clinic letters were then reviewed to see if patients were listed for repeat hydrodilatation or surgical arthroscopic capsular rupture,
within 6 months of the original procedure.
This was the main outcome assessed during the audit.
Total fluid volume used was recorded from the procedure report.
The average volume used for each patient outcome was...
Results
83 fluoroscopic shoulder hydrodilatation procedures performed at Aintree University Hospital,
between 01/01/17 to 31/12/17,
were found in the initial search.
See figures 1-3 for image examples of the procedure.
11 patients did not attend clinic follow up and were excluded from the results,
giving a total of 72 patients.
The results for patient outcome were as follows (see Table 1):
No further intervention was needed following 59/72 (82%) procedures
5/72 (6.9%) were listed for repeat hydrodilatation within 6 months
8/72 (11.1%) were listed for surgical...
Conclusion
The results suggest fluoroscopic shoulder hydrodilatation is an effective treatment for adhesive capsulitis,
with only a small proportion of patients needing further intervention.
They indicate it is a good option for secondary care management and it may avoid the need for surgery in a significant proportion of patients.
Results of the fluid volume used were inconclusive; there was not a significant difference in each group suggesting this may not have a great influence on procedure success.
Suggestions to expand on the findings of this audit...
References
Hannafin,
Jo,
A.; Chiaia,
Theresa,
A.
Adhesive Capsulitis: A Treatment Approach. Clinical Orthopaedics and Related Research:March 2000 - Volume 372 - Issue - p 95-109
Amar Rangan,
Lorna Goodchild,
Jo Gibson,
Peter Brownson,
Michael Thomas,
Jonathan Rees and Ro Kulkarni.
Frozen Shoulder. BESS/BOA Patient Care Pathways.
Shoulder & Elbow 2015,
Vol.
7(4) 299–307