Correlations between MRI findings and outcome of capsular distension in adhesive capsulitis of the shoulder.
Yun Hee Park, Young Sook Park, Hyun Jung Chang and 1 others
PMID 27821938WHAT IT FOUND
MRI capsule thickness and fat replacement grades did not predict better pain or passive motion outcomes after ultrasonography-guided capsular distension plus physical therapy in 57 patients.
All groups improved, but capsular distension and physical therapy were given together, so neither can be credited alone.
Key findings
01Capsular thickness and fat replacement grades did not predict different pain or passive motion outcomes after treatment.
02Pain and passive motion improved significantly from baseline to 9 weeks after injection in all grade groups.
03Capsular distension and physical therapy were delivered together, so their separate contributions cannot be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective and did not control for patient factors such as clinical stage or severity of adhesive capsulitis. All patients received ultrasonography-guided capsular distension plus physical therapy, so the contribution of either component cannot be separated. The study analyzed only patients who received capsular distension and physical therapy, so it did not compare them with patients who received either component alone. The authors did not evaluate the effect of combined shoulder pathology, such as rotator cuff lesions. The MRI examination did not include enhanced imaging, which may limit comparison with earlier studies. The 20 ml capsular distension volume may not have reached enough joint expansion in patients with mild adhesive capsulitis.
Declared interests
No potential conflicts of interest relevant to this article are reported.
The easy way to misread this
Do not use MRI capsular thickness or fat replacement grades to expect a better response. The study found no significant difference between grades in pain or passive motion outcomes after the combined capsular distension and physical therapy protocol.