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Steroid injections are widely utilized to reduce inflammation and fibrosis in patients with the frozen shoulder. In this study, investigators will compare intra-articular steroid injections with direct coracohumeral ligament steroid injection to conventional intra-articular steroid injection. Investigators will measure the primary outcome as shoulder function improvement and secondary outcomes as ROM, pain scale and stiffness of coracohumeral ligament under elastogram.
Adhesive capsulitis of the shoulder, also known as the frozen shoulder, often leads to severe pain and shoulder range of motion limitation. Steroid injections are widely utilized to reduce inflammation and fibrosis. The thickening of the coracohumeral ligament was thought to play an important role in the pathogenesis of frozen shoulder, resulting in limited external rotation of the shoulder. While the elastogram of coracohumeral ligament will significantly increase stiffness under the shear-wave ultrasound (shear-wave elastography).
Therefore, in this study, investigators will compare intra-articular steroid injections with direct coracohumeral ligament steroid injection to conventional intra-articular steroid injection. Investigators will measure the primary outcome as shoulder function improvement and secondary outcomes as ROM, pain scale and stiffness of coracohumeral ligament under elastogram.
(the patient will not have additional risk of injection under ultrasound guidance)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PT+IA+CHL | Experimental |
|
|
| PT+IA | Active Comparator |
|
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intraarticular triamcinolone injection | Procedure | triamcinolone 10mg/mL |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Shoulder function (The Disabilities of the Arm, Shoulder and Hand Score, QuickDash) improvement | shoulder function improvement (The Disabilities of the Arm, Shoulder and Hand Score, QuickDash), score 0-100 | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Change of Visual analogue scale | Visual analogue scale: scale 0-10 | 2 years |
| Shoulder range of motion improvement | Range of motion improvement: flexion, abduction, external rotation (degree) |
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A.Inclusion criteria:
B.Exclusion criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chueh-Hung Wu | Contact | 0972651208 | nojred@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Chueh-Hung Wu, MD | NTUH PMR | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Test1 | Test2 | test3 | Taiwan |
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| Intraarticular Xylocaine injection |
| Procedure |
Xylocaine 1% 4ml |
|
| Coracohumeral ligament triamcinolone injection | Procedure | triamcinolone 10mg/mL |
|
| Physiotherapy | Procedure |
|
| 2 years |
| Stiffness of coracohumeral ligament under elastogram (KPa) | 2 years |
| ID | Term |
|---|---|
| D002062 | Bursitis |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D026741 | Physical Therapy Modalities |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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