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Abstract：
UNASSIGNED: Corticosteroid injection and physical therapy remain the mainstay of treatment for idiopathic adhesive capsulitis of the shoulder; however, a certain percentage of patients will not improve using these interventions and will require manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA).
UNASSIGNED: To evaluate whether the immediate pain reduction after fluoroscopic-guided, mixed anesthetic-corticosteroid injection for idiopathic adhesive capsulitis is related to the eventual need for LOA/MUA or a repeat glenohumeral steroid injection.
UNASSIGNED: Case-control study; Level of evidence, 3.
UNASSIGNED: This single-institution study involved patients undergoing fluoroscopic glenohumeral corticosteroid injection for a diagnosis of idiopathic adhesive capsulitis between 2010 and 2017. Included were patients with a minimum of 1-year postinjection follow-up and visual analog scale (VAS) pain scores from immediately before and after the injection. The primary analysis was the relationship between patients with an immediate change in VAS score after injection and those who underwent LOA/MUA. A repeat glenohumeral injection was also evaluated as an outcome. Receiver operator characteristic curves and a multivariate binomial logistic regression analysis were performed.
UNASSIGNED: Overall, 739 shoulders in 728 patients (mean age, 52.6 years; 68% women) were included, of which 38 (5.1%) underwent LOA/MUA and 209 (28%) underwent repeat injections. The immediate change in the VAS score was not significantly associated with the eventual need for LOA/MUA. Preinjection VAS and immediate postinjection VAS scores were not significant predictors of eventual LOA/MUA or subsequent injection. For all 3 predictors, the area under the receiver operator characteristic curve classified them as extremely poor discriminators.
UNASSIGNED: The immediate pain response to a fluoroscopic-guided glenohumeral injection for idiopathic shoulder adhesive capsulitis was not predictive of the eventual need for LOA/MUA or subsequent injection. Patients can be counseled that even if their initial pain response to an injection is poor, they still have an excellent chance of avoiding surgery, as the overall rate of LOA/MUA was low (5.1%).
UNASSIGNED: To evaluate whether the immediate pain reduction after fluoroscopic-guided, mixed anesthetic-corticosteroid injection for idiopathic adhesive capsulitis is related to the eventual need for LOA/MUA or a repeat glenohumeral steroid injection.
UNASSIGNED: Case-control study; Level of evidence, 3.
UNASSIGNED: This single-institution study involved patients undergoing fluoroscopic glenohumeral corticosteroid injection for a diagnosis of idiopathic adhesive capsulitis between 2010 and 2017. Included were patients with a minimum of 1-year postinjection follow-up and visual analog scale (VAS) pain scores from immediately before and after the injection. The primary analysis was the relationship between patients with an immediate change in VAS score after injection and those who underwent LOA/MUA. A repeat glenohumeral injection was also evaluated as an outcome. Receiver operator characteristic curves and a multivariate binomial logistic regression analysis were performed.
UNASSIGNED: Overall, 739 shoulders in 728 patients (mean age, 52.6 years; 68% women) were included, of which 38 (5.1%) underwent LOA/MUA and 209 (28%) underwent repeat injections. The immediate change in the VAS score was not significantly associated with the eventual need for LOA/MUA. Preinjection VAS and immediate postinjection VAS scores were not significant predictors of eventual LOA/MUA or subsequent injection. For all 3 predictors, the area under the receiver operator characteristic curve classified them as extremely poor discriminators.
UNASSIGNED: The immediate pain response to a fluoroscopic-guided glenohumeral injection for idiopathic shoulder adhesive capsulitis was not predictive of the eventual need for LOA/MUA or subsequent injection. Patients can be counseled that even if their initial pain response to an injection is poor, they still have an excellent chance of avoiding surgery, as the overall rate of LOA/MUA was low (5.1%).
摘要：
■皮质类固醇注射和物理治疗仍然是特发性肩关节粘连性囊炎的主要治疗手段；然而，使用这些干预措施,一定比例的患者不会好转,需要麻醉下操作(MUA)和/或粘连松解术(LOA).
■为了评估透视引导下疼痛是否立即减轻，用于特发性粘连性囊炎的麻醉药-皮质类固醇混合注射与最终需要LOA/MUA或重复盂肱类固醇注射有关.
■病例对照研究；证据水平，3.
■这项单机构研究涉及在2010年至2017年期间接受荧光镜检查的肱骨皮质类固醇注射以诊断特发性粘连性囊炎的患者。包括注射后至少1年随访的患者，以及注射前后即刻的视觉模拟评分（VAS）疼痛评分。主要分析是注射后VAS评分立即变化的患者与接受LOA/MUA的患者之间的关系。重复肱骨头注射也被评估为结果。进行了受试者操作特征曲线和多变量二项逻辑回归分析。
■总的来说，728名患者的739名肩膀(平均年龄，52.6岁；68%的女性）被包括在内，其中38例(5.1%)接受了LOA/MUA,209例(28%)接受了重复注射.VAS评分的立即变化与最终需要LOA/MUA没有显著关联。注射前VAS和注射后立即VAS评分不是最终LOA/MUA或后续注射的重要预测因子。对于所有3个预测因子，接收器操作员特征曲线下的区域将它们分类为极差的鉴别器。
■对于特发性肩关节粘连性囊炎，透视引导下的肩关节腔内注射的即刻疼痛反应并不能预测最终需要LOA/MUA或后续注射。可以建议患者，即使他们对注射的初始疼痛反应很差，他们仍然有很大的机会避免手术，由于LOA/MUA的总体比率较低（5.1％）。
■为了评估透视引导下疼痛是否立即减轻，用于特发性粘连性囊炎的麻醉药-皮质类固醇混合注射与最终需要LOA/MUA或重复盂肱类固醇注射有关.
■病例对照研究；证据水平，3.
■这项单机构研究涉及在2010年至2017年期间接受荧光镜检查的肱骨皮质类固醇注射以诊断特发性粘连性囊炎的患者。包括注射后至少1年随访的患者，以及注射前后即刻的视觉模拟评分（VAS）疼痛评分。主要分析是注射后VAS评分立即变化的患者与接受LOA/MUA的患者之间的关系。重复肱骨头注射也被评估为结果。进行了受试者操作特征曲线和多变量二项逻辑回归分析。
■总的来说，728名患者的739名肩膀(平均年龄，52.6岁；68%的女性）被包括在内，其中38例(5.1%)接受了LOA/MUA,209例(28%)接受了重复注射.VAS评分的立即变化与最终需要LOA/MUA没有显著关联。注射前VAS和注射后立即VAS评分不是最终LOA/MUA或后续注射的重要预测因子。对于所有3个预测因子，接收器操作员特征曲线下的区域将它们分类为极差的鉴别器。
■对于特发性肩关节粘连性囊炎，透视引导下的肩关节腔内注射的即刻疼痛反应并不能预测最终需要LOA/MUA或后续注射。可以建议患者，即使他们对注射的初始疼痛反应很差，他们仍然有很大的机会避免手术，由于LOA/MUA的总体比率较低（5.1％）。
