Ultrasound-guided Versus Blind Subacromial Corticosteroid and Local Anesthetic Injection in the Treatment of Subacromial Impingement Syndrome: A Randomized Study of Efficacy

Abstract

Objectives: This study aims to compare the effects of ultrasound(US)-guided and blind subacromial corticosteroid and localanesthetic (LA) injection in the treatment of subacromialimpingement syndrome (SIS) on shoulder pain, range of motion(ROM), and functionality.Patients and methods: The prospective study was conductedbetween 01 February 2017 and 31 May 2017. A total of 29 patientswith clinical findings and magnetic resonance imaging (MRI)consistent with SIS were randomized into two groups: 14 patientsreceived US-guided subacromial corticosteroid and LA injectionand 15 patients received a blind subacromial corticosteroid andLA injection. Patients were evaluated before and one monthafter treatment. One patient was lost to follow up. The primaryoutcome measure was a visual analog scale (VAS) for shoulderpain. Secondary outcomes were active shoulder ROM in flexionand abduction, the Disabilities of the Arm, Shoulder, and Hand(DASH) questionnaire and the modified Constant-Murley Score(CMS).Results: Twenty eight patients (11 males, 17 females; mean age39.5 in the US guided group and 42.5 in the blind group; range20 to 64 years in both groups) completed the study. There was asignificant improvement in VAS for shoulder pain, active ROM,DASH questionnaire score and modified CMS in both groupsfour weeks after treatment (p