POS1292 ULTRASONOGRAPHIC GUIDED INTRA ARTICULAR STEROID AND HYALURONIC ACID IN ADHESIVE CAPSULITIS WITH AND WITHOUT SUPRASCAPULAR NERVE BLOCK

Abstract

Background: Adhesive capsulitis (AC), often known as frozen shoulder, is a common musculoskeletal condition characterised by shoulder pain and reduced active and passive mobility. Intra‐articular injections is an effective treatment option and provide faster pain relief in patients with AC Objectives: Compare the effictiveness of intra articular injection (IAI) of steroid and HA with or without Suprascapular nerve block (SSNB) in the management of AC. Methods: Randomized control trial involved 80 patients (62 women and 18 men) clinically diagnosed as having adhesive capsulitis divided into 2 main groups; intra articular injection with SSNB (40 cases) and without SSNB (40 cases), each group divided into 2 subgroups; Twenty patients were treated with ultrasound guided intra articular injection of steroid (4ml of 2% lidocaine and 2 ml of 40 mg/ml triamcinolone) and another twenty patients were treated with ultrasound guided intra articular injection of hyaluronic acid (4 ml of 2% lidocaine and 2 ml hyaluronic acid). Results: Intra articular shoulder injection with SSNB has higher signifcant visual analogue scale (VAS) score at baseline and lower signifcant VAS score at 1st and 3rd week (p < 0.001). However, there was no signifcance between both groups regarding disability score at 3rd weak (p=0.316). In contrast, there was a high signifcance between them considering disability score at baseline, 1st, 6th weak (p<0.001 and 0.008, respectively). Conclusion: In patients with adhesive capsulitis, both a combination an IAI alone or with SSNB dramatically improved pain and functional results. The use of an SSNB in conjunction with an IAI especially with steroid enhanced therapeutic effectiveness.