Fibro-adhesive Bursitis: A Novel Sonographic Finding in Adhesive Capsulitis Patients and a Proposal of Management

Autor: Fabio Vita, Roberta Gualtierotti, Marco Miceli, Roberto Tedeschi, Flavio Origlio, Marco Cavallo, Stefano Galletti, Salvatore Massimo Stella, Enrico Guerra, Danilo Donati, Cesare Faldini
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Rheumatology and Therapy, Vol 11, Iss 6, Pp 1519-1532 (2024)
Druh dokumentu: article
ISSN: 2198-6576
2198-6584
DOI: 10.1007/s40744-024-00716-8
Popis: Abstract Introduction Adhesive capsulitis, also known as “frozen shoulder,” is a debilitating shoulder condition increasingly linked to fibroadhesive bursitis, particularly after COVID-19 and related vaccinations. There is no definitive gold standard for its treatment, the primary therapeutic objectives of which are the reduction of pain and the restoration of shoulder range of motion. The aim of our study was to analyze treatment outcomes based on quantitative measures of shoulder function and symptom relief. Method Conducted between January 2022 and April 2023, the research involved 45 patients initially diagnosed with adhesive capsulitis and associated fibroadhesive bursitis. After excluding nine patients for other concomitant pathologies (five for calcific tendinopathy and four for rotator cuff injury), 36 patients were randomized into two groups: one group was treated with glenohumeral hydrodistension, the other with glenohumeral hydrodistension combined with bursal injection. Assessments were conducted at baseline and then 2, 4, and 6 months after treatment, focusing on changes in pain levels, functional scores, and range of motion in all planes. Each group followed a home-based rehabilitation protocol. Results Significant improvements were observed in both treatment groups, with the combined hydrodistension and bursal injection group showing notably superior outcomes. Specifically, the range of motion in flexion improved from an initial median of 80° to 155° in the combined treatment group, compared to an increase from 75.5° to 129° in the group treated with hydrodistension alone. This enhancement was statistically significant (p
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