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MedEdPORTAL 2018 Sep 15;14:10749. Epub 2018 Sep 15.

Associate Professor, General Internal Medicine, Wake Forest Baptist Health.

Introduction: Although musculoskeletal (MSK) complaints are very common in ambulatory clinics, internal medicine residents report low confidence in performing MSK examinations and intra-articular steroid injections. Our goal is to strengthen residents' MSK competence by using visual, auditory, and kinesthetic educational modalities during an academic half-day session.

Methods: Our intervention was a workshop/academic half-day session that included multimodal educational materials on common shoulder and knee MSK complaints. Read More

Am J Sports Med 2019 Mar 13;47(4):915-921. Epub 2019 Feb 13.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA.

Background:: Corticosteroid injections are sometimes used in the postoperative period after shoulder arthroscopy; however, a well-defined safety profile has not been established.

Purpose:: To examine the association between the timing of postoperative corticosteroid injections and rates of infection after shoulder arthroscopy.

Study Design:: Cohort study; Level of evidence, 3. Read More

BMJ 2019 Feb 6;364:l294. Epub 2019 Feb 6.

Department of Orthopaedic Surgery and Traumatology, Joint Research, OLVG, Amsterdam, The Netherlands

Clinical Question: Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery.

Current Practice: SAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections. Surgeons frequently perform arthroscopic subacromial decompression for prolonged symptoms, with guidelines providing conflicting recommendations. Read More

Musculoskeletal Care 2019 Jan 8. Epub 2019 Jan 8.

Rehabilitation Department, John Hopkins Healthcare Aramco, Dhahran, Kingdom of Saudi Arabia.

Background: Subacromial impingement syndrome (SAIS) is the most common cause of shoulder pain and is costly, in terms of disability and health service provision. Research evidence suggests that, generally, the anterior, lateral and posterior approaches are used by clinicians for subacromial injection. However, it is uncertain which of these approaches is more effective than the other in the management of SAIS. Read More

Arthroscopy 2019 Feb 3;35(2):325-331. Epub 2019 Jan 3.

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address:

Purpose: To determine whether an association exists between preoperative shoulder injections and reoperations in patients undergoing arthroscopic rotator cuff repair (aRCR).

Methods: The PearlDiver Patient Records Database was reviewed for Humana-insured patients undergoing aRCR after a shoulder injection. Two matched groups were created: aRCR within 1 year of injection (n = 12,054) and aRCR without prior injection within 1 year of surgery (n = 12,054). Read More

Arthroscopy 2019 Jan 22;35(1):45-50. Epub 2018 Nov 22.

Department of Orthopedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.. Electronic address:

Purpose: To identify any dose-dependent association between the use of subacromial corticosteroid injections within a year before rotator cuff repair (RCR) and subsequent need for revision rotator cuff surgery.

Methods: Two large administrative databases were queried for patients undergoing arthroscopic RCR. A minimum of 1 year of preoperative database exposure and 2 years of postoperative database follow-up were required for inclusion. Read More

J Ultrason 2018 ;18(74):234-239

Oxford University and St Lukes Radiology Oxford Ltd, Oxford, UK.

Diagnosis is crucial in decision-making when treating a patient with shoulder pain. Ultrasound is also very important in the diagnostic and therapeutic pathway, especially when surgery is being considered. This article outlines the diagnostic pathway using the patient's history, physical examination and ultrasound examination. Read More

Orthopedics 2019 Jan 14;42(1):e44-e50. Epub 2018 Nov 14.

The authors sought to compare the accuracy and effectiveness of the mid-lateral and posterior routes of subacromial injection. They conducted a prospective randomized study involving 50 shoulders scheduled to receive subacromial injection via the midlateral or posterior route. After injection, a blinded musculoskeletal radiologist interpreted the radiographs. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(4):261-265

Ortopedicko-traumatologické oddělení, Nemocnice Znojmo.

PURPOSE OF THE STUDY This study aimed to explore the effects of new therapeutic procedures in patients with shoulder impingement syndrome. The primary goal of the study was to confirm the hypothesis that the application of the platelet-rich plasma (PRP) in patients with shoulder impingement syndrome will have a positive effect on both the subjective and objective evaluation of their condition. The clinical condition before and after the treatment was evaluated. Read More

Med Sci Sports Exerc 2019 Feb;51(2):227-233

Department of Cardiology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Huazhong University of Science and Technology, Wuhan, CHINA.

Purpose: The treatment of partial-thickness rotator cuff tears (PTRCT) remains controversial. Few studies have focused on the conservative and new measurements of small to medium PTRCT. The use of sodium hyaluronate (SH) or platelet-rich plasma (PRP) as a method for rotator cuff repair requires further investigation. Read More

Arthroscopy 2018 Oct 6;34(10):2765-2774. Epub 2018 Sep 6.

Lovisenberg Diaconal Hospital, Oslo, Norway.

Purpose: The aim of this study was to compare clinical and radiologic results among patients with 3 versus 6 weeks of immobilization after arthroscopic rotator cuff (RC) repair in a prospective randomized controlled non-inferiority trial.

Methods: One hundred twenty patients were included after RC surgery for a small- to medium-sized tear of supraspinatus and upper infraspinatus tendons. Group A was immobilized in a simple sling for 3 weeks, and group B had a brace with a small abduction pillow with the arm in neutral position for 6 weeks. Read More

Acta Ortop Mex 2018 Mar-Apr;32(2):70-75

Departamento de Cirugía Ortopédica y Traumatología. Hospital Universitario Insular de Gran Canaria. España.

Objective: Our purpose was to assess the effectiveness of hyaluronic acid infiltrations for chronic shoulder pain as an alternative to the non-surgical and surgical treatments that are currently available.

Material And Methods: This is a prospective study of 80 consecutive patients suffering from chronic shoulder pain followed for twelve months. Five subacromial hyaluronic acid injections on five consecutive weeks were administrated to all patients. Read More

Medicine (Baltimore) 2018 Aug;97(35):e12078

Background: Hemiplegic shoulder pain (HSP) is one common complication after stroke. The interferes with the functionality of the affected shoulder in patients with stroke during rehabilitation. Hyaluronic acid (HA) could have positive effects on pain relief and shoulder motion in stroke patients with hemiplegic shoulders. Read More

J Pain Res 2018 25;11:1239-1245. Epub 2018 Jun 25.

Physical Medicine and Rehabilitation Unit, Ospedali Riuniti, Università di Foggia, Foggia,

Introduction: Shoulder pain is one of the most common musculoskeletal diseases, and can be due to glenohumeral osteoarthritis, rotator cuff tear, impingement, tendinitis, adhesive capsulitis, and subacromial bursitis. Several therapies have been proposed, including steroids, nonsteroidal anti-inflammatory drugs, intra-articular injections, and physical therapies. Many published studies have reported on the employment of botulinum toxin type A (BoNT-A) to reduce pain in subjects with neurological and musculoskeletal diseases by inhibiting substance P release and other inflammatory factors. Read More

Shoulder Elbow 2018 Jul 5;10(3):170-178. Epub 2017 Jun 5.

Orthopaedic Research Institute, St George Hospital Campus, Sydney, NSW, Australia.

Background: Subacromial corticosteroid injections are frequently performed for pain associated with supraspinatus tendinopathy. Glucose prolotherapy has been used clinically for multiple tendinopathies and is hypothesized to be an alternate injection therapy for supraspinatus tendinopathy.

Methods: A prospective, randomized, double blinded clinical trial was conducted. Read More

Clin Radiol 2018 Aug 18;73(8):760.e7-760.e12. Epub 2018 Jun 18.

Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Great George Street, Leeds, LS1 3EX, UK.

Aim: To assess shoulder pain and disability in patients undergoing corticosteroid injection into the subacromial-subdeltoid (SA-SD) bursa under ultrasound guidance, evaluating both short and long-term outcomes.

Materials And Methods: In this prospective, longitudinal, analytical study 376 patients referred for SA-SD bursa injection during a 6 month period were asked to complete a questionnaire assessing shoulder pain and disability in the form of the Shoulder Pain and Disability Index (SPADI). Patients were reassessed at 6 weeks and 12 months post-injection. Read More

J Clin Orthop Trauma 2018 Mar 7;9(Suppl 1):S80-S85. Epub 2017 Feb 7.

Department of Orthopaedics, GTB Hospital & UCMS, Delhi 110095, India.

Objective: Impingement syndrome is the most common differential in a patient presenting to an orthopaedic OPD with shoulder pain. Impingement syndrome is often managed with subacromial corticosteroid injection, which can be instilled using either landmark guided (LMG) approach or with the assistance of ultrasound (US). This study was envisaged to enquire whether ultrasound assistance improves the accuracy, efficacy or safety profile of the injection. Read More

Orthop Clin North Am 2018 Apr 19;49(2):231-239. Epub 2017 Dec 19.

Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.

Rotator cuff disease affects a large proportion of the overall population and encompasses a wide spectrum of pathologies, including subacromial impingement, rotator cuff tendinopathy or tear, and calcific tendinitis. Various injection therapies have been used for the treatment of rotator cuff disease, including corticosteroid, prolotherapy, platelet-rich plasma, stem cells, and ultrasound-guided barbotage for calcific tendinitis. However, the existing evidence for these therapies remains controversial or sparse. Read More

PeerJ 2018 23;6:e4400. Epub 2018 Feb 23.

Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark.

Background: Impaired patient-reported shoulder function and pain, external-rotation strength, abduction strength, and abduction range-of-motion (ROM) is reported in patients with subacromial impingement (SIS). However, it is unknown how much strength and ROM improves in real-life practice settings with current care. Furthermore, outcomes of treatment might depend on specific rehabilitation parameters, such as the time spent on exercises (exercise-time), number of physiotherapy sessions (physio-sessions) and number of corticosteroid injections, respectively. Read More

Eur J Orthop Surg Traumatol 2018 Aug 8;28(6):1079-1087. Epub 2018 Feb 8.

Sport and Orthopedic Center, Samitivej Hospital, Bangkok, Thailand.

Background: In symptomatic tendinosis, a corticosteroid injection into the subacromial space is a palliative treatment option. This study compares high volumes (10 cc) of local anesthetic (LA) combined with triamcinolone acetate (TA) with low volumes (4 cc) of LA combined with TA to see whether the latter would provide similar pain, function and complication outcomes for subacromial injections in patients with impingement syndrome.

Materials And Methods: This single-center, randomized, single-blind, non-inferiority trial included patients with shoulder pain and positive multiple clinical tests supporting the diagnosis of impingement syndrome. Read More

J Res Pharm Pract 2017 Oct-Dec;6(4):223-227

Departement of Internal Medicine, Poursina Hakim Research Institute for Health Care Development, Isfahan, Iran.

Objective: Subacromial impingement syndrome is the most common cause of shoulder pain and restriction in range of motion in the world. The aim of this study was to compare the efficacy of subacromial injection of ketorolac with the injection of corticosteroid for the treatment of subacromial impingement syndrome.

Methods: A total of forty patients were randomly allocated into two groups. Read More

J Shoulder Elbow Surg 2018 May 1;27(5):771-776. Epub 2018 Feb 1.

Orthopaedic Department, Shoulder-Elbow Section, University of Düsseldorf, Düsseldorf, Germany.

Hypothesis: We hypothesized that the prevalence of Propionibacterium acnes in patients undergoing primary shoulder arthroscopy is equal in the glenohumeral space compared with the subacromial space.

Methods: Patients aged 18 years or older with shoulder arthroscopies were included. The exclusion criteria were prior shoulder operations, complete rotator cuff tears, systemic inflammatory diseases, tumors, shoulder injections within 6 months of surgery, and antibiotic therapy within 14 days preoperatively. Read More

Br J Sports Med 2018 Apr 5;52(8):497-504. Epub 2018 Jan 5.

School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK.

Objective: To compare the effectiveness of corticosteroid injections to local anaesthetic injections in the management of rotator cuff-related shoulder pain (RCRSP).

Design: Systematic review with best evidence synthesis.

Data Sources: The Cochrane, PubMed, CINAHL Plus, PEDro and EMBASE electronic databases were searched (inception until 8 June 2017). Read More

Am J Sports Med 2018 03 21;46(3):663-670. Epub 2017 Dec 21.

Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Background: Corticosteroid injection is a common treatment for frozen shoulder, but controversy still exists regarding the injection site with the best outcome.

Hypothesis: To treat the frozen shoulder in the freezing stage with corticosteroid injection, a single injection into the rotator interval (RI) could yield better effects in terms of improvement in pain, passive range of motion (ROM), and function than would an injection into the intra-articular (IA) or subacromial (SA) space.

Study Design: Randomized controlled trial; Level of evidence, 1. Read More

JNMA J Nepal Med Assoc 2017 Jul-Sep;56(207):357-61

Department of Orthopedics, Lumbini Zonal Hospital and Lumbini Hospital and Technical College, Butwal, Nepal.

Introduction: Acute calcific tendinitis of shoulder is very painful and disturbing condition. There are many modalities with variable outcome to address the condition. We studied needling technique with multiple fenestration, subacromial steroid and diclofenac phonophoresis and evaluated the outcome in term of pain relief and improvement of shoulder function at a simple outpatient clinical set up without image or ultrasound guidance. Read More

Arch Bone Jt Surg 2017 Sep;5(5):315-321

Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

Background: Corticosteroid injections are used to treat a variety of orthopedic conditions with the goal of decreasing pain and inflammation. Administration of systemic or local corticosteroids risks temporarily increasing blood glucose levels, especially diabetic patients. The purpose of this study is to quantify the effects of corticosteroid injections on blood glucose levels in diabetic patients with shoulder pathology. Read More

Rev Med Inst Mex Seguro Soc 2017 Sep-Oct;55(5):608-614

Departamento de Salud en el Trabajo, Unidad de Medicina Familiar No. 61, Instituto Mexicano del Seguro Social, Veracruz, Veracruz, México

Background: The most common cause of injury is shoulder impingement syndrome. Management includes physical therapy, analgesics, steroids and surgery. The aim of the study was to determine the cost-effectiveness of using steroids combined with therapeutic exercise at home in the chronic impingement syndrome. Read More

J Am Acad Orthop Surg 2017 Dec;25(12):799-807

From the Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD (Dr. McFarland, Dr. Dein, and Dr. Johnson), and the National Sports Medicine Institute, Leesburg, VA (Dr. Bernard).

Injections about the shoulder serve diagnostic as well as therapeutic purposes. Diagnosis of shoulder conditions, such as rotator cuff tears, acromioclavicular joint pathology, subacromial impingement or anterolateral pain syndrome, glenohumeral joint pathology, suprascapular nerve entrapment, and biceps tendon pathologies, is often complicated by concomitant conditions with overlapping symptoms and by inconclusive physical examination and imaging results. Injections of anesthetic agents can often help clinicians locate the source of pain. Read More

Altern Ther Health Med 2018 Jan;24(1):56-60

Context • Shoulder pain is one of the most common pain complaints reported by patients. Consensus is lacking on its ideal treatment, and many different treatments are available and used. Prolotherapy is an injection-based therapy that has shown significant results in treating many common musculoskeletal pain conditions, including osteoarthritis, lateral epicondylosis, and low-back pain. Read More

Eur J Orthop Surg Traumatol 2018 Apr 12;28(3):397-407. Epub 2017 Oct 12.

Sport and Orthopedic Center, Samitivej Hospital, Bangkok, Thailand.

Subacromial impingement syndrome (SIS) is one of the most frequent pathologies of the shoulder, which may cause serious restriction of daily activities and lifestyle changes. Corticosteroid injection (CI) into the subacromial space is a palliative treatment option. Currently, there have been no studies that compare between the different volumes of CI injection. Read More

Am J Orthop (Belle Mead NJ) 2017 Jul/Aug;46(4):E257-E262

Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA.

Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Treatment options for SIS include conservative modalities such as use of nonsteroidal anti-inflammatory drugs, physical therapy, and subacromial corticosteroid injections (CSIs). Although studies have found improvement in pain, function, and range of motion after CSI, the effect of injection route (anterior or posterior) on shoulder pain in patients with SIS has not been investigated. Read More

Vaccine 2017 09 31;35(37):4870-4876. Epub 2017 Jul 31.

Area Pharmacology, Departament of Medicine, Oviedo University, Spain.

While vaccination injection site adverse reactions are usually mild and transient in nature, several cases of bursitis and other shoulder injuries have been reported in the medical literature. However, these lesions are not included in vaccine label inserts. To identify the characteristics of post-vaccination shoulder injuries and those of patients and involved vaccines, as well as their potential causes, a systematic review of the cases of vaccination-related bursitis and other shoulder injuries reported in the literature and notified to the Spanish Pharmacovigilance System database (FEDRA) have been conducted. Read More

Am J Phys Med Rehabil 2018 Jan;97(1):56-61

From the Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (SWL, TT, BL, MNB); Hofstra Northwell School of Medicine, Hofstra University, Hempstead, New York (JR); and Kessler Institute for Rehabilitation, Kessler Foundation, Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Neward, New Jersey (MO-P).

Objective: The aims of the study were to assess the overall reduction of pain in patients undergoing ultrasound-guided shoulder injections and to characterize the preinjection point-of-care ultrasound findings and use of clinical services postinjection including the use of magnetic resonance imaging and surgeries.

Design: Data of 172 patients who underwent ultrasound-guided subacromial subdeltoid injection or glenohumeral joint injection were reviewed for preinjection point-of-care ultrasound findings, change in pain intensity at 2 mos from baseline, and use of care at 6 mos' postinjection. Pain intensity was measured by the numeric rating scale and a dichotomous report of global impression of significant improvement in pain. Read More

Muscles Ligaments Tendons J 2017 Jan-Mar;7(1):34-39. Epub 2017 May 10.

Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, USA.

Background: Subacromial corticosteroid injections (CSI's) are a common non-surgical treatment for rotator cuff tears. Few studies have assessed the effects of pre-operative CSI's on postoperative functional outcomes.

Methods: A retrospective analysis was conducted of 132 patients with high-grade, partial-thickness rotator cuff tears (PTRCT's). Read More

J Shoulder Elbow Surg 2017 Oct 6;26(10):1789-1793. Epub 2017 Jul 6.

Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Arthroscopic rotator cuff (RC) repair incorporates suture anchors to secure torn RC tendons to the greater tuberosity (GT) bone. RC repair strength depends on the anchor-bone interface and on the quality of the GT. We evaluated the effect of single and multiple corticosteroid injections on the pullout strength of suture anchors. Read More

Clin Med Insights Arthritis Musculoskelet Disord 2017 12;10:1179544117713196. Epub 2017 Jun 12.

Department of Human Physiology, University of Oregon, Eugene, OR, USA.

Shoulder proprioception gives information regarding arm joint position and movement direction. Several studies have investigated shoulder proprioceptive acuity in patients with subacromial impingement syndrome (SIS); however, differences in protocols and between-subjects designs have limited scientific inferences regarding proprioception and SIS. We aimed to determine within-subject differences in shoulder and elbow proprioceptive acuity in 17 patients with stage 2 SIS following treatment of a local anesthetic injection. Read More

Sports Med Open 2017 Dec 5;3(1):22. Epub 2017 Jun 5.

Medical Department, OPKO Health Europe, Barcelona, Spain.

Background: Physical therapy and peritendinous hyaluronic acid (HA) injections have both shown promising results in the treatment of shoulder tendinopathies. However, the superiority of treatment combining physical therapy and HA is unclear.

Methods: Patients with ultrasound-confirmed supraspinatus tendinopathy were randomized to receive either physical therapy + subacromial HA injections or physical therapy only. Read More

BMC Musculoskelet Disord 2017 04 4;18(1):138. Epub 2017 Apr 4.

Department for Physical Medicine and Rehabilitation, Oslo University Hospital, P.O.B. 4956, Nydalen, 0424, Oslo, Norway.

Background: For the treatment of calcific tendinitis of the shoulder a variety of treatment regimes exist. Commonly used treatment measures include medication with oral analgesics, corticosteroid injections, extracorporeal shockwave therapy, ultrasound guided needling and lavage, and surgical treatment. Earlier cohort studies suggest that patients may benefit from these treatments, but there are few randomized studies and conflicting evidence about the effectiveness of the various treatments. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Jan 2;26(1):79-87. Epub 2017 Mar 2.

Department of Orthopedics, NU-Hospital Group Trollhättan/Uddevalla, Uddevalla Sjukhus, 451, Uddevalla, Sweden.

Purpose: The purpose of the present study was to analyze biopsy samples from the subscapularis tendon and from the joint capsule from male patients with shoulder impingement syndrome (SAIS) and compare them with samples from male patients with post-traumatic recurrent shoulder instability. The hypothesis of the study was that patients with SAIS would have more histologic and ultrastructural degenerative changes in their subscapularis tendon and joint capsule than patients with post-traumatic recurrent shoulder instability.

Methods: Male patients scheduled for surgery, with either subacromial decompression or Bankart reconstruction, were included. Read More

Arch Phys Med Rehabil 2017 10 27;98(10):1984-1994. Epub 2017 Feb 27.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

Objective: To explore factors contributing to initial effectiveness and recurrence after ultrasound (US)-guided subacromial corticosteroid injections by assessing clinical measurements and static and dynamic shoulder US images.

Design: Retrospective cohort study.

Setting: Rehabilitation outpatient clinic. Read More

Pain Ther 2017 Jun 9;6(1):45-60. Epub 2017 Feb 9.

Utah Orthopaedic Specialists, Salt Lake City, USA.

Introduction: What is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery?

Methods: Retrospective 10-year review of a shoulder surgeon's practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire. Read More

J Orthop Surg (Hong Kong) 2017 01;25(1):2309499016684470

1 Department of orthopaedics, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India.

Background: Frozen shoulder is not an uncommon disorder, and steroid injection into the glenohumeral (GH) joint is one of the most well-known approaches for the frozen shoulder. However, their results have been varied with beneficial effects or no additional advantage. With the understanding about the pathological changes taking place in frozen shoulder and the biomechanics involved, we wanted to evaluate the short- and long-term efficacy of steroid injection by a novel three-site (NTS) injection technique and compare it with the single-site injection (SSI). Read More

Int J Neurosci 2017 Nov 25;127(11):958-964. Epub 2017 Jan 25.

a Department of Physical Medicine and Rehabilitation , College of Medicine, Yeungnam University , Daegu , Republic of Korea.

Purpose: We attempted to investigate whether ultrasound (US)-guided intra-articular or subacromial bursa corticosteroid injections can potentially influence the severity of depression and anxiety in patients with chronic stroke with hemiplegic shoulder pain (HSP).

Methods: Thirty patients with chronic stroke with HSP received US-guided corticosteroid injections. Numeric rating scale (NRS) scores, passive shoulder range of motion (ROM), Beck Depression Inventory (BDI) scores and Spielberger State-Trait Anxiety Inventory (STAI) scores were evaluated before the injection, and one and two months after the injection. Read More

Arch Phys Med Rehabil 2017 05 27;98(5):881-887. Epub 2016 Dec 27.

Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address:

Objective: To evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in patients with rotator cuff disease.

Design: Prospective, longitudinal comparison study.

Setting: University-affiliated tertiary care hospital. Read More

Medicine (Baltimore) 2016 Dec;95(49):e5547

aDepartment of Physical Medicine and Rehabilitation bDepartment of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Background: Hemiplegic shoulder pain (HSP) is one of the most common comorbidities in stroke patients with flaccid shoulders. The pain limits functional motor recovery and affects the activities of daily living after acute stroke. This study investigated the effects of hyaluronic acid (HA) injection on pain reduction and motor function in subacute stroke patients with HSP and injury. Read More

Man Ther 2016 Dec 5;26:216-222. Epub 2016 Oct 5.

Menzies Health Institute Queensland, Griffith University, Parklands Drive Southport, QLD 4222, Gold Coast, Australia.

Background: Physiotherapists increasingly manage shoulder referrals in place of orthopaedic doctors. Better understanding the agreement between these professionals will help inform the safety, quality and potential costs of these care models.

Objective: To establish the level of agreement between a physiotherapist and an orthopaedic surgeon regarding diagnosis, management and corticosteroid injection, in a representative sample of orthopaedic shoulder referrals. Read More

Am J Sports Med 2017 Jun 13;45(7):1676-1686. Epub 2016 Oct 13.

Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Background: Effective postoperative pain management after shoulder arthroscopy is a critical component to recovery, rehabilitation, and patient satisfaction.

Purpose: This systematic review provides a comprehensive overview of level 1 and level 2 evidence regarding postoperative pain management for outpatient arthroscopic shoulder surgery.

Study Design: Systematic review. Read More

Acta Orthop Belg 2016 Aug;82(2):166-173

Shoulder disorders are common in the general population : they occur in about 25 of every 1000 patients per year. A rather large majority are caused by cuff disorders. Differentiating between impingement and cuff rupture is essential to adequate treatment. Read More