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Skeletal Radiology
Published in: Skeletal Radiology 5/2023

30-07-2022 | Ultrasound | Scientific Article

Ultrasound-guided hydrodistension for adhesive capsulitis: a longitudinal study on the effect of diabetes on treatment outcomes

Authors: Sofia Dimitri-Pinheiro, Michail E. Klontzas, Madalena Pimenta, Evangelia E. Vassalou, Raquel Soares, Apostolos H. Karantanas

Published in: Skeletal Radiology | Issue 5/2023

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Abstract

Objective

The effect of diabetes on adhesive capsulitis (AC) and its impact on the outcomes of ultrasound (US)-guided hydrodistension of the glenohumeral joint are still unclear. We aimed to identify predictors of US-guided hydrodistension outcomes, while assessing the performance of the method in diabetic compared to non-diabetic patients.

Materials and methods

A total of 135 patients with AC who underwent US-guided hydrodistension were prospectively included. Demographics and factors linked to chronic inflammation and diabetes were recorded and patients were followed-up for 6 months. Functionality and pain were evaluated with the Disabilities of the Arm, Shoulder and Hand (DASH) and the Visual Analogue Scale (VAS) score. Statistical analysis was performed with Mann–Whitney U test, linear, and binary logistic regression.

Results

Diabetes was identified in 25/135 patients (18.5%). Diabetic patients had worse DASH and VAS score at presentation (P < 0.0001) and presented with a higher grade of AC (P < 0.0001) and lower range of motion (P < 0.01) compared to non-diabetics. Higher DASH (P = 0.025) and VAS scores (P = 0.039) at presentation were linked to worse functionality at 6 months. Presence and duration of diabetes, and the number of hydrodistension repeats, correlated with worse VAS and DASH scores at 6 months. The number of procedure repeats was the only independent predictor of complete pain resolution at 6 months (OR 0.418, P = 003).

Conclusion

Diabetes is linked to more severe AC at presentation and worse outcomes in patients undergoing US-guided hydrodistension. In resistant cases, repeating the intervention is independently linked to worse outcomes for at least 6 months post-intervention.
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Metadata
Title
Ultrasound-guided hydrodistension for adhesive capsulitis: a longitudinal study on the effect of diabetes on treatment outcomes
Authors
Sofia Dimitri-Pinheiro
Michail E. Klontzas
Madalena Pimenta
Evangelia E. Vassalou
Raquel Soares
Apostolos H. Karantanas
Publication date
30-07-2022
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 5/2023
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-04141-2

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