Gavant M L, Rizk T E, Gold R E, Flick P A
Department of Radiology, University of Tennessee, Memphis College of Medicine 38163.
J Vasc Interv Radiol. 1994 Mar-Apr;5(2):305-8. doi: 10.1016/s1051-0443(94)71488-3.
Adhesive capsulitis involving the glenohumeral joint (frozen shoulder) is an insidious and painful condition that results in gradual loss of joint motion. Recovery is frequently prolonged despite multiple therapeutic maneuvers. The authors investigate the mechanism of action and the long-term clinical result of distention arthrography for the treatment of patients with frozen shoulder.
Sixteen patients with adhesive capsulitis of the shoulder were treated with therapeutic capsular distention by using intra-articular injection of a 30-mL mixture of lidocaine, corticosteroid, and contrast media immediately following diagnostic arthrography.
Capsular disruption was demonstrated in all cases. Thirteen patients (80%) experienced immediate pain relief and increased shoulder mobility. This improvement was maintained over a follow-up interval of 6 months or more. Disruption occurred at the subscapular bursa in eight patients, the subacromial bursa in six, and the distal bicipital tendon sheath in two. These latter two patients had no pain relief.
Arthrographic distention of the constricted capsule appears to be an excellent therapeutic intervention for achieving rapid symptomatic relief from adhesive capsulitis.
累及盂肱关节的粘连性关节囊炎（肩周炎）是一种隐匿性疼痛疾病，会导致关节活动逐渐丧失。尽管采取了多种治疗手段，恢复过程仍常常迁延不愈。作者研究了扩张性关节造影术治疗肩周炎患者的作用机制及长期临床效果。
16例肩周炎患者在诊断性关节造影术后，通过关节内注射30毫升利多卡因、皮质类固醇和造影剂的混合液进行治疗性关节囊扩张。
所有病例均显示关节囊破裂。13例患者（80%）疼痛立即缓解，肩部活动度增加。这种改善在6个月或更长时间的随访期内得以维持。8例患者肩胛下囊破裂，6例肩峰下囊破裂，2例肱二头肌远端腱鞘破裂。后两位患者疼痛未缓解。
对狭窄关节囊进行造影扩张似乎是一种能迅速缓解粘连性关节囊炎症状的极佳治疗干预手段。
