BLIND OR ULTRASOUND-GUIDED CORTICOSTEROIDS INJECTIONS AND SHORT TERM RESPONSE IN SUBACROMIAL IMPINGEMENT SYNDROME: A RANDOMIZED, DOUBLE BLINDED, PROSPECTIVE STUDY

Background: Subacromial injection of corticosteroids is an effective therapy in subacromial impingement syndrome (SIS). Efficacy, as well as accurate placement, have been questioned (1,2). Objectives: To investigate requirement between blind and ultrasound (US)-guided injection into subacromial space and the treatment effectivenessu Methods: 46 consecutive patients with SIS randomized for blind (Group1, n=23) and US-guided injection (Group 2, n=23). Injections was performed by phisiatrist (posteriorly) or by an musculoskeletal radiologist (laterally). A mixture betamethasone dipropionate, prilocaine and gadolinium-DTPA was injected and immediatelly after injection magnetic resonance imaging was performed. All patients were clinically assessed before injections and 6 weeks after injection by another phisiatrist. Clinical assesment included demographic and clinical data, according to Constant Range of Motion, activities of daily living and pain, visual analog scale (rest, night, motion), Shoulder Disability Questionnare and postinjection adverse effects. Results: In Group 1, 16 (70%), and in Group 2, 15 (65%) subacromial injections were performed, and no statistically significant difference could be found regarding injection location accuracy (p>0,05). On all patients in both groups istatistically significant improvement was detected at the end of the 6th week when compared with the baseline (p<0.05). At the end of 6th week all patients irrespective of injected mixture found in the subacromial region or not, statistically significantly improved in all parameters (p<0.05). Conclusion: Blind injection into subacromial space is reliable so it can be used in daily routine applications. Moreover, due to disturabition of corticosteroids into neighbouring structures to the injecred area, improvement in symptomps will be observed. References: 1. Kang MN, Rizio L, Prybicien M, Middlemas DA, Blacksin MF. The accuracy of subacromial corticosteroid injections: a comparison of multiple methods. J Shoulder Elbow Surg 2008;17:61-66. 2. Naredo E, Cabero F, Beneyto P, Cruz A, Mondéjar B, Uson J, Palop MJ, Crespo M. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol. 2004;31:308-14. Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 69, supplement 3, year 2010, page 707Session: Back pain, mechanical musculoskeletal problems, local soft tissue disorders (Abstracts accepted for publication )