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Ultrasound-guided hydrodistension for adhesive capsulitis: a longitudinal study on the effect of diabetes on treatment outcomes

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Abstract

Objective

The effect of diabetes on adhesive capsulitis (AC) and its impact on the outcomes of ultrasound (US)-guided hydrodistension of the glenohumeral joint are still unclear. We aimed to identify predictors of US-guided hydrodistension outcomes, while assessing the performance of the method in diabetic compared to non-diabetic patients.

Materials and methods

A total of 135 patients with AC who underwent US-guided hydrodistension were prospectively included. Demographics and factors linked to chronic inflammation and diabetes were recorded and patients were followed-up for 6 months. Functionality and pain were evaluated with the Disabilities of the Arm, Shoulder and Hand (DASH) and the Visual Analogue Scale (VAS) score. Statistical analysis was performed with Mann–Whitney U test, linear, and binary logistic regression.

Results

Diabetes was identified in 25/135 patients (18.5%). Diabetic patients had worse DASH and VAS score at presentation (P < 0.0001) and presented with a higher grade of AC (P < 0.0001) and lower range of motion (P < 0.01) compared to non-diabetics. Higher DASH (P = 0.025) and VAS scores (P = 0.039) at presentation were linked to worse functionality at 6 months. Presence and duration of diabetes, and the number of hydrodistension repeats, correlated with worse VAS and DASH scores at 6 months. The number of procedure repeats was the only independent predictor of complete pain resolution at 6 months (OR 0.418, P = 003).

Conclusion

Diabetes is linked to more severe AC at presentation and worse outcomes in patients undergoing US-guided hydrodistension. In resistant cases, repeating the intervention is independently linked to worse outcomes for at least 6 months post-intervention.

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Authors and Affiliations

  1. Radiology Department, Portuguese Institute of Oncology of Porto – Francisco Gentil EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal

    Sofia Dimitri-Pinheiro

  2. Biomedicine Department, Unit of Biochemistry, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Sofia Dimitri-Pinheiro & Raquel Soares

  3. Department of Medical Imaging, University Hospital of Heraklion, 71110, Voutes, Heraklion, Crete, Greece

    Michail E. Klontzas, Evangelia E. Vassalou & Apostolos H. Karantanas

  4. Department of Radiology, School of Medicine, University of Crete, Voutes Campus, 71003, Heraklion, Crete, Greece

    Michail E. Klontzas & Apostolos H. Karantanas

  5. Radiology Department, São João Hospital Centre, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal

    Madalena Pimenta

  6. I3S - Institute for Innovation and Health Research, University of Porto, Rua Alfredo Allen, 2084200-135, Porto, Portugal

    Raquel Soares

Authors
  1. Sofia Dimitri-Pinheiro
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Dimitri-Pinheiro, S., Klontzas, M.E., Pimenta, M. et al. Ultrasound-guided hydrodistension for adhesive capsulitis: a longitudinal study on the effect of diabetes on treatment outcomes. Skeletal Radiol 52, 1005–1014 (2023). https://doi.org/10.1007/s00256-022-04141-2

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  • DOI: https://doi.org/10.1007/s00256-022-04141-2

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