Francesca Lacelli MD, Abstract Co-Author: Nothing to Disclose

Chiara Martini MChir, Abstract Co-Author: Nothing to Disclose

Davide Orlandi MD, Presenter: Nothing to Disclose

Giovanni Serafini MD, Abstract Co-Author: Nothing to Disclose

Adhesive capsulitis (AC) is characterized by pain and stiffness in external rotation and abduction of the upper limb; physiatric rehabilitation (PR) is often difficult.The suprascapular nerve (SN) supplies70% of shoulder sensitive innervation.US visualizes the SN at the level of the spine of the scapula.The purpose of this work is to show that SN block makes a more lasting pain decrease than the intra-articular treatment of capsulitis and makes the PR easier

20 patients with clinical diagnosis of adhesive capsulitis were randomized in 2groups (A=10F, y=45±3.2; B=10F, y=44±3.6).Group A was treated with US-guided intra-articular injection of 5cc of hydrocloride mepivacaine2%, 40mg of methylprednisolone and 6ml(90mg) of hyaluronate.In group B the US-guided perineural (at the level of the spine of the scapula) injection of 5cc of hydrocloride mepivacaine2% was added to the treatment.All patients began PR the day of treatment. All patients underwent clinical (VAS scale and ROM index) both before than immediately after the treatment, at 1week and 1month.

VAS before: 8.9 (A), 9.1 (B); immediately after: 5.0(A), 4.8(B); at 1week: 6.2 (A), 4.5 (B); at 1month: 6.1 (A), 4.0 (B) (p<0.01). ROM before: 100°(A), 95°(B); immediately after: 120°(A,B); at 1week: 130°(A), 150°(B); at 1month: 135°(A), 170°(B).We had not complications, in particular no deficit of motion. In all patients of group B we visualized the SN by ultrasound.

The role of physiatry in rehabilitation and reduction of pain is fundamental.The SN block associated with intra-articular treatment allows an improvement of PR.The SN block has a more lasting effect than intra-articular treatment.

Ultrasound guided SN block  is recommended to improve efficency of rehabilitation in patient with shoulder capsulitis.

Lacelli, F, Martini, C, Orlandi, D, Serafini, G, US-guided Block of Suprascapular Nerve as a Treatment of Adhesive Capsulitis: Indications, Technique and Early Results.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014232.html