Arthrographic Findings of Frozen Shoulder and Therapeutic Effect of Distension Arthrography

ABSTRACT

OBJECTIVE: To define arthrographic findings in patients with frozen shoulder and to evaluate the therapeutic effect of arthrographic capsular distension and rupture. METHOD: Thirty patients who were clinically diagnosed as frozen shoulder were enrolled. During a trial of intra-articular injection of 35 mL of fluid which contained 8 mL of 1% lidocaine, 2 mL of prednisolone (80 mg) and 25 mL of radiocontrast material, arthrographic findings and the occurrence of iatrogenic capsular tear were observed. Passive range of shoulder motion (percent of normal, %) at flexion, abduction, internal rotation, and external rotation was measured at pre- and 1 week post-injection. The therapeutic effect of the procedure was statistically analyzed by paired Student's t-test. RESULTS: Mean age of the subjects was 57-years-old (range 40~76 years) and mean duration of the symptom was 6 months (2~42 months). A decreased joint volume of less than 10 mL (100%), poor or absent filling of the axillary recess or subscapular bursa (75.9%), nonfill of the biceps tendon sheath (37.9%), and irregularity of capsular insertion (31.0%) were typical abnormal arthrographic findings. In one week after arthrographic distension and rupture, the passive range of shoulder motion was significantly (p<0.05) increased at flexion, abduction and external rotation, of which the range of external rotation was the most remarkably increased (mean, 23.9%). CONCLUSION: Distension arthrography was useful for increasing shoulder motion in frozen shoulder, especially at flexion, abduction and external rotation.