초음파를 이용한 견봉하 점액낭 내 스테로이드 주사 효과: 두 가지 용량의 비교
Ultrasonography-guided Subacromial Bursal Injection of Corticosteroid: A Comparative Study of Two Dose Regimens
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Objective: To investigate the treatment efficacy between low and high dose of triamcinolone acetonide in the treatment of ultrasonographic-guided subacromial bursa injection. Method: Forty two patients with periarticular shoulder disorders were randomly assigned to receive injection with 10 mg (group 1, 20 patients) or 40 mg (group 2, 22 patients) triamcinolone acetonide. After a single injection, participants were followed up for 6 weeks. Treatment efficacy was measured upon pre-treatment and post-treatment on week 1, 3, 6, using visual analog scale for average pain intensity during 24 hours (24 h VAS), Shoulder Function Assessment scale (SFA), Shoulder Disability Questionnaire (SDQ), and active range of motion (AROM). Participants and the assessor were blinded for group assignment. Results: Six weeks after injection, the 24 h VAS, the SFA, the SDQ, and the AROM (internal rotation, external rotation, and abduction) showed a significantly greater improvement in group 2 than group 1 (p<0.05). Conclusion: This study showed that in the treatment of periarticular shoulder disorders greater pain relief and functional improvement were obtained with a dose of 40 mg triamcinolone acetonide than with a dose of 10 mg.
Abstract
Objective: To investigate the treatment efficacy between low and high dose of triamcinolone acetonide in the treatment of ultrasonographic-guided subacromial bursa injection. Method: Forty two patients with periarticular shoulder disorders were randomly assigned to receive injection with 10 mg (group 1, 20 patients) or 40 mg (group 2, 22 patients) triamcinolone acetonide. After a single injection, participants were followed up for 6 weeks. Treatment efficacy was measured upon pre-treatment and post-treatment on week 1, 3, 6, using visual analog scale for average pain intensity during 24 hours (24 h VAS), Shoulder Function Assessment scale (SFA), Shoulder Disability Questionnaire (SDQ), and active range of motion (AROM). Participants and the assessor were blinded for group assignment. Results: Six weeks after injection, the 24 h VAS, the SFA, the SDQ, and the AROM (internal rotation, external rotation, and abduction) showed a significantly greater improvement in group 2 than group 1 (p<0.05). Conclusion: This study showed that in the treatment of periarticular shoulder disorders greater pain relief and functional improvement were obtained with a dose of 40 mg triamcinolone acetonide than with a dose of 10 mg.
참고문헌 (32)
- Blair B, "Efficacy of injections of corticosteroids for subacromial impingement syndrome", J Bone Joint Surg Am, 78, pp.1685~1689 (1996)
- Darlington LG, "The effects of local steroid injection for supraspinatus tears", Rheumatol Rehabil, 16, pp.172~179 (1977)
- White RH, "Rotator cuff tendinitis: comparison of subacromial injection of a long acting corticosteroid versus oral indomethacin therapy", J Rheumatol, 13, pp.608~613 (1986)
- Naredo E, "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, 31, pp.308~314 (2004)
- Chen MJL, "Ultrasound-guided shoulder injections in the treatment of subacromial bursitis", Am J Phys Med Rehabil, 85, pp.31~35 (2006)
- Brue S, "Idiopathic adhesive capsulitis of the shoulder: a review", Knee Surg Sports Traumatol Arthrosc, 15, pp.1048~1054 (2007)
- Neer CS, "The shoulder in sports", Orthop Clin North Am, 8, pp.583~591 (1977)
- Hawkins RJ, "Impingement syndrome in athletes", Am J Sports Med, 8, pp.151~158 (1980)
- Yocum LA, "Assessing the shoulder. History, physical examination, differential diagnosis, and special tests used", Clinsports Med, 2, pp.281~289 (1983)
- Jobe FW, "Painful athletic injuries of the shoulder", Clin Orthop Relat Res, 173, pp.117~124 (1983)
- Leroux JL, "Diagnostic value of clinical tests for shoulder impingement syndrome", Rev Rhum Engl Ed, 62, pp.423~428 (1995)
- Gerber C, "Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases", J Bone Joint Surg Br, 73, pp.389~394 (1991)
- Yergason RM, "Supination sign", J Bone Joint Surg, 13, pp.160~ (1931)
- Gilcreest EL, "Dislocation and elongation of the long head of the biceps brachii: an analysis of six cases", Ann Surg, 104, pp.118~138 (1936)
- Van Holsbeeck M, "Musculoskeletal ultrasonography", Radiol Clin North Am, 30, pp.907~925 (1992)
- Backhaus M, "Guidelines for musculoskeletal ultrasound in rheumatology", Ann Rheum Dis, 60, pp.641~649 (2001)
- Naredo E, "Painful shoulder: comparison of physical examination and ultrasonographic findings", Ann Rheum Dis, 61, pp.132~136 (2002)
- 박기영, "건염에 있어 초음파 검사와의 상관관계", Annals of Rehabilitation Medicine, 27(2), pp.16~249 (2003), 대한재활의학회
- Allen GM, "Ultrasound of the shoulder", Eur J Ultrasound, 14, pp.3~9 (2001)
- Crass JR, "Ultrasonography of rotator cuff tears: a review of 500 diagnostic studies", J Clin Ultrasound, 16, pp.313~327 (1988)
- van Den Ende CH, "Assessment of shoulder function in rheumatoid arthritis", J Rheumatol, 23, pp.2043~2048 (1996)
- Croft P, "Measurement of shoulder related disability: results of a validation study", Ann Rheum Dis, 53, pp.525~528 (1994)
- Carr AJ, "Orthopaedics in primary care, 2nd ed", pp.1~18 (2005), Butterworth-Heinemann
- Bartolozzi A, "Determinants of outcome in the treatment of rotator cuff disease", Clin Orthop Relat Res, 308, pp.90~97 (1994)
- Yamakado K, "The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation", Arthroscopy, 18, pp.887~891 (2002)
- Henkus HE, "The accuracy of subacromial injections: a prospective randomized magnetic resonance imaging study", Arthroscopy, 22, pp.277~282 (2006)
- Partington PF, "Diagnostic injection around the shoulder: hit and miss? a cadaveric study of injection accuracy", J Shoulder Elbow Surg, 7, pp.147~150 (1998)
- Eustace JA, "Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms", Ann Rheum Dis, 56, pp.59~63 (1997)
- de Jong BA, "Intra-articular triamcinolone acetonide injection in patients with capsulitis of the shoulder: a comparative study of two dose regimens", Clin Rehabil, 12, pp.211~215 (1998)
- Plafki C, "Local anaesthetic injection with and without corticosteroids for subacromial impingement syndrome", Int Orthop, 24, pp.40~42 (2000)
- Kesson M, "Musculoskeletal injection skills", pp.48~ (2003), Butterworth-Heinemann
- Saunders S, "Injection techniques in orthopaedic and sports medicine, 2nd ed", pp.36~37 (2002), Saunders
