Ultrasound-Guided Hydrodilatation Versus Corticosteroid Injection for Adhesive Capsulitis: A Pilot Randomized Comparative Study

Objectives This pilot randomized comparative study aimed to evaluate the feasibility and preliminary effectiveness of ultrasound-guided hydrodilatation (HD) compared with intra-articular corticosteroid injection (IAI) in patients with adhesive capsulitis at six weeks. Methods A prospective, single-blind, feasibility randomized comparative study was conducted in a tertiary rheumatology centre. Twenty patients with adhesive capsulitis were recruited and randomized equally to receive HD (n = 10) and IAI (n = 10). The primary outcome measures included the Shoulder Pain and Disability Index (SPADI) score, QuickDASH questionnaire score, pain visual analogue scale (VAS), and range of motion (ROM) at six weeks post-intervention. Results Results were reported as mean (± SEM, SD) or median (interquartile range), depending on the distribution of the data. At six weeks, the pain VAS scores were 5 (2, 6) and 1.5 (0.25, 3.75) in the HD and IAI groups, respectively, with P = 0.36. SPADI-Pain scores were 37.8 (17.7-57.8) and 25.3 (5.6-45.0) in the HD and IAI groups, respectively, with P = 0.325. SPADI-Disability scores were 47.3 (26.3-68.3) and 28.5 (8.1-48.9) in the HD and IAI groups, respectively, with P = 0.1602. Median QuickDASH scores were 29.1 (14.5, 41.8) and 13.6 (4.5, 27.3) in the HD and IAI groups, respectively, with P = 0.437. Active and passive ROM also showed no in-between group differences. Conclusion No short-term differences between HD and IAI were seen in all the domains studied. Both treatment groups demonstrated improvement in pain and function at six weeks. However, we are unable to conclude that the two treatments have equivalent effectiveness due to the pilot design. The preliminary data may be used to inform larger studies with longer follow-up to determine optimal treatment strategies.