Positive outcomes with intra-articular glenohumeral injections are independent of accuracy

Journal of Shoulder and Elbow Surgery
Eric J HegedusAllison Tobola

Abstract

Shoulder pain is a common, costly, and recalcitrant affliction. One treatment for shoulder pain is intra-articular injection of corticosteroid. Clinical opinion is that injection guided by palpation is accurate and effective, and there is some evidence to support a positive effect of injection on pain. However, great controversy exists as to the accuracy of injection by palpation, whether or not accuracy is important, and what the effect is of accuracy on pain. We used a blinded, longitudinal observational design of effectiveness in an effort to determine the accuracy of intra-articular injections and the effect of that accuracy on pain and functional outcomes in patients with various shoulder pathologies. Injection accuracy data were captured on 103 patients. Of the 103 blinded injections, 54 received injections that were identified by fluoroscopy as "in" the capsule, whereas 49 were identified as "outside" the capsule; an accuracy rate of 52.4%. In the 4-week follow up, regardless of group assignment or accuracy of the injection, patients improved significantly (P < .01) from pre- to post-injection. Improvement was typically over by 2.5 points in the Numeric Pain Rating Scale (NPRS) categories, over 8 points on the Short-Form...Continue Reading

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Citations

Jun 28, 2011·BMC Musculoskeletal Disorders·Edmund SohDianne Bautista
Sep 29, 2011·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Bernardo Gialanella, Paola Prometti
Jan 15, 2013·Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine·Eric J HegedusAlexis A Wright
Jul 30, 2011·Journal of Shoulder and Elbow Surgery·Matthew J KraeutlerChristopher C Dodson
Oct 18, 2013·Geriatrics & Gerontology International·Bernardo Gialanella, Maurizio Bertolinelli
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Jan 16, 2014·Sports Health·Christopher GrossAnthony Romeo
Jul 21, 2016·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Ryan C XiaoArun J Ramappa
Nov 28, 2017·The Journal of the American Academy of Orthopaedic Surgeons·Edward McFarlandAlex Johnson

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