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Updates on the treatment of adhesive capsulitis with hydraulic distension

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Author(s)
Jang Hyuk Cho
Keimyung Author(s)
Cho, Jang Hyuk
Department
Dept. of Rehabilitation Medicine (재활의학)
Journal Title
Yeungnam University Journal of Medicine
Issued Date
2021
Volume
38
Issue
1
Keyword
InflammationJoint capsulePainShoulder joint
Abstract
Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.
Keimyung Author(s)(Kor)
조장혁
Publisher
School of Medicine (의과대학)
Citation
Jang Hyuk Cho. (2021). Updates on the treatment of adhesive capsulitis with hydraulic distension. Yeungnam University Journal of Medicine, 38(1), 19–26. doi: 10.12701/yujm.2020.00535
Type
Article
ISSN
2384-0293
Source
https://www.e-yujm.org/journal/view.php?number=2604
DOI
10.12701/yujm.2020.00535
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43333
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
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