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

Sep 28, 2026

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This pilot randomized comparative study evaluates the feasibility and preliminary effectiveness of ultrasound-guided hydrodilatation (HD) versus intra-articular corticosteroid injection (IAI) for adhesive capsulitis at six weeks. A prospective, single-blind feasibility trial recruited 20 patients, randomized equally to HD (n=10) or IAI (n=10). Primary outcomes included SPADI, QuickDASH, pain VAS, and ROM. No short-term between-group differences were observed; both groups improved pain and function, though pilot design limited equivalence conclusions.

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Abstract

Objectives

Methods

Results

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Introduction

Condition overview

Clinical staging

Treatment context

Received 07/03/2025 Review began 09/10/2025 Review ended 11/26/2025 Published 12/03/2025 © Copyright 2025 Chew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98413 Open Access Original Article Published via The Hong Kong Institute Of Musculoskeletal Medicine Ultrasound-Guided Hydrodilatation Versus Corticosteroid Injection for Adhesive Capsulitis: A Pilot Randomized Comparative Study Li-Ching Chew 1, 2, 3 , Tyng Yu Chuah 4, 2 , Cassandra Hong 1, 2 , Christopher Wei Yang Liu Benjamin Sachdev 6, 7 5 , 1. Rheumatology and Immunology, Singapore General Hospital, Singapore, SGP 2. Duke-NUS Medical School, DukeNUS Academic Medical Centre, Singapore, SGP 3. Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SGP 4. Rheumatology, Sengkang General Hospital, Singapore, SGP 5. Pain Medicine, Singapore General Hospital, Singapore, SGP 6. Rheumatology, Singapore General Hospital, Singapore, SGP 7. Rheumatology Unit, Department of Medicine, Hospital Raja Perempuan Zainab II, Kota Bharu, MYS Corresponding author: Li-Ching Chew, [chew.li.ching@singhealth.com.sg](chew.li.ching@singhealth.com.sg) Abstract 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) inpatients 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 inbetween 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. Categories: Physical Medicine & Rehabilitation, Pain Management, Rheumatology Keywords: adhesive capsulitis, corticosteroid, frozen shoulder, hydrodilatation, intra-articular agents, quickdash score, spadi score, ultrasonography Introduction Adhesive capsulitis, also known as frozen shoulder, is a common, functionally debilitating condition characterized by shoulder pain and progressive limitation of both active and passive range of motion (ROM) of the glenohumeral joint [1-3]. It can be divided into primary (idiopathic) or secondary conditions; the latter may be due to either intrinsic (local muscular, tendon pathologies, or rotator cuff tear), extrinsic (abnormalities away from the shoulder, such as cervical radiculopathy o

FAQs

What treatments were compared in this pilot study?

The study compared ultrasound-guided hydrodilatation (HD) with intra-articular corticosteroid injection (IAI) for patients with adhesive capsulitis.

What outcomes were assessed at six weeks?

Outcomes included SPADI (pain and disability), QuickDASH, pain VAS, and range of motion (active and passive ROM).

Did HD and IAI differ in effectiveness at six weeks?

No short-term differences were seen between HD and IAI across the studied domains; both groups showed improvement at six weeks.

Sep 28, 2026

Uploaded by Patrick