Adhesive capsulitis of the shoulder: Therapeutic contribution of subacromial bursography

Objective. To demonstrate the therapeutic value of subacromial bursography (with a steroid injection) in adhesive capsulitis of the shoulder inadequat ely improved by arthrographic glenohumeral distension with steroid injectio n. Method. Twenty cases of adhesive capsulitis documented by glenohumeral a rthrography were studied prospectively. A steroid was injected during diste nsion arthrography, which was followed by physical therapy. Subacromial bur sography without steroid injection was done routinely for diagnostic purpos es. Constant's simplified score and range of motion were determined in each patient at baseline and after one, three, six and 12 months. Patients who were inadequately improved after one to three months underwent repeat subac romial bursography with steroid injection, followed by physical therapy. Re sults. Of the 20 patients, 13 were noticeably improved 1.7 months on averag e after the distension arthrography. Of the remaining seven patients, six w ere improved 0.7 months on average after the bursography with steroid injec tion. Conclusion. Glenohumeral distension arthrography with steroid injecti on followed by physical therapy is effective in expediting the spontaneousl y favorable outcome of adhesive capsulitis and also allows to confirm the d iagnosis. However, the subacromial bursa is almost consistently involved. S ubacromial bursography with steroid injection can be useful in cases that f ail to respond to conventional therapy.