Effectiveness of oral prednisone or corticosteroid injection therapy administered into the glenohumeral joint with ultrasonography in patients with adhesive capsulitis and evaluation in terms of axillary (inferior) pouch thickness

Objective: The aim of this study was to evaluate the efficacy of oral prednisone or corticosteroid therapy administered into the glenohumeral joint with ultrasonography in patients with adhesive capsulitis and its evaluation in terms of axillary (inferior) pouch thicknesses. Methods:Our study included 48 patients aged 18-65 years with shoulder joint range of motion and painful clinical prediagnosis of AK. Individuals were randomly divided into injection and oral groups.After obtaining the demographic information of all individuals, the first group determined by the randomization scheme was administered glenohumeral injection with 3 ml of 2% prilocaine and 1 ml of 20 mg triamsonolone hexacetenoid mixture under the guidance of USG, and oral prednisone 0.5 mg/kg was administered to the other group in doses of 4 mg for 5 days. reduced. Physical therapy was started in both groups at the same time. After 3 weeks of exercise, the patients continued with home exercises. SPADI questionnaire, goniometric active and passive ROM measurements, ultrasonographic evaluation and axillary pouch thickness measurements (AR) were performed on the day of the study and at the 6th week. Results: The study included 24 patients with a mean age of 55.16±6.39 years in the steroid injection group and 24 patients with a mean age of 55.37±8.1 years in the oral prednisone group. A statistically significant difference was found between the mean values of flexion, abduction, extension, internal and external rotation determined as passive-active before and after the treatment in both groups of patients who participated in our study (p<0.05). It was determined that the values of active and passive flexion, abduction, extension, internal and external rotation after the treatment in patients who received steroid injection were more positive than the patients who received oral steroids (p<0.05). In the injection group, the mean value of the inferior pouch measured by USG was before treatment (3.91±0.47) and after treatment (2.50±0.39). In the oral treatment group, the mean value of the inferior pouch measurement by USG was 3.65 (3.65±0.65) before the treatment and 2.6 (2.76±0.69) after the treatment. There was no statistically significant difference between the patients who received steroid injection and oral treatment in terms of pouch thickness measurements obtained by USG after treatment (p>0.05). Conclusion:Based on these data, there was a decrease in shoulder pain questionnaire and a significant increase in passive-active range of motion, flexion and abduction in both groups, more significantly in the steroid injection+FTR group in AK patients. Although the axillary pouch thickness values decreased in both groups after the treatment, there was no difference when compared to each other. There is a need for new studies with larger groups in the hope that ultrasonography will be a criterion in the diagnosis and treatment of Adhesive Capsulitis.