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The effect of injection volume on long-term outcomes of US-guided subacromial bursa injections.
- Source :
-
European Journal of Radiology . Aug2020, Vol. 129, pN.PAG-N.PAG. 1p. - Publication Year :
- 2020
-
Abstract
- <bold>Purpose: </bold>Limited data exist on the efficacy of high- compared to low-volume US-guided corticosteroid injections (CI) in the subacromial-subdeltoid (SA-SD) bursa. Our purpose was to compare the short- and long-term efficacy of low- and high-volume injections, by using a capacity reference of SA-SD bursa volume, as assessed on cadaveric specimens.<bold>Method: </bold>Within two years, 136 patients (63 males, 73 females; mean age: 46.11 ± 10.28 years) who underwent SA-SD bursa US-guided CI for subacromial impingement, rotator cuff tendinopathy or shoulder overuse were prospectively included. Patients were randomly assigned to low-volume (1 mL triamcinolone acetonide/40 mg) or high-volume (1 mL triamcinolone acetonide/40 mg, 9 mL anaesthetic agents) groups (67 and 69 patients, respectively). Visual Analogue Scores (VAS) were recorded at baseline, 30 min, 3 weeks, 3 months, 6 months and 1 year post-treatment. Predictors of complete recovery (VAS ≤ 2) at 1 year were analysed with multivariate Cox regression analysis. SA-SD bursa cadaveric dissection in 10 specimens was performed for volume assessment.<bold>Results: </bold>Injection volume was the only predictor of complete pain resolution at 1 year. High-volume CI yielded higher chances of early pain recovery (2.837 HR, 95% CI 1.737-4.633, P < .001). Mean VAS scores at baseline and subsequent time-points were 6, 2.6, 2.2, 2, 1.6 and 1 for the high-volume and 7.8, 7.3, 4.7, 3.2, 2.5 and 1.8 for the low-volume group, respectively (P < .001, at all time-points). Cadaveric measurements showed a minimum SA-SD bursa volume of approximately 6.9 mL.<bold>Conclusions: </bold>High-compared to low-volume US-guided CI are superior for achieving early pain recovery. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ROTATOR cuff
*INJECTIONS
*SHOULDER pain
*RESEARCH
*ADRENOCORTICAL hormones
*ULTRASONIC imaging
*TRIAMCINOLONE
*SHOULDER joint
*SHOULDER injuries
*RESEARCH methodology
*SHOULDER disorders
*EVALUATION research
*MEDICAL cooperation
*TREATMENT effectiveness
*COMPARATIVE studies
*RANDOMIZED controlled trials
*DOSE-effect relationship in pharmacology
*INTRA-articular injections
*LONGITUDINAL method
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 0720048X
- Volume :
- 129
- Database :
- Academic Search Index
- Journal :
- European Journal of Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 144502012
- Full Text :
- https://doi.org/10.1016/j.ejrad.2020.109113