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Local corticosteroid injections in the treatment of rotator cuff tendinitis (except for frozen shoulder and calcific tendinitis). Groupe Rhumatologique Francais de l'Epaule (G.R.E.P.).

Goupille P, Sibilia J.

Clin Exp Rheumatol 1996 Sep-Oct 14:5 561-6


OBJECTIVE: This review discusses the efficacy of local corticosteroid injections in the treatment of rotator cuff tendinitis (except for frozen shoulder and calcific tendinitis) according to the controlled studies published in the literature.
STUDY SELECTION: All controlled studies (13) published between 1955 and 1993 have been included in this review. However, this work is not a metaanalysis because these studies are not comparable.
DATA SYNTHESIS: Several studies are open to criticism. Local corticosteroid injections seem to be more effective than placebo and oral non-steroidal antiinflammatory drugs, especially for pain. Several questions remain unanswered: the true position of this treatment in the therapeutic strategy of rotator cuff tendinitis, the long term efficacy and deleterious effects of local corticosteroid injections and the optimal technique and number of injections.

CONCLUSION: Local corticosteroid injections seem to be effective in the treatment of rotator cuff tendinitis. However, a controlled study more closely reflecting clinical practice is needed to confirm these data.

Comparison of injection techniques for shoulder pain: results of a double blind, randomised study.

Hollingworth GR,Ellis RM,Hattersley TS

Br Med J (Clin Res Ed) 1983 Nov 5 287:6402 1339-41

Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different methods of corticosteroid injection with local anaesthetic in a randomly allocated double blind study. The method of anatomical injection after diagnosis by the technique of selective tissue tension gave 60% success compared with the method using tender or trigger point localisation, giving 20% success (p less than 0.001).

Accurate Diagnosis and Treatment in Painful Shoulder Conditions.

G Symonds , MB, BS, Registrar in Rheumatology, The Middlesex Hospital, London, England

J Int Med Res 1975 3,261 1339-41

Seventy unselected patients with painful shoulders were examined by a systematic clinical method based on applied anatomy. In every patient, except one, the tissue or tissues at fault were identiefied; Cases of tendinitis, sub-deltoid and sub)coracoid bursitis , 'frozen shoulder' and acromio-calvicular joint arthrosis were treated by appropriate local infiltrations with 10 mg triamcinolone ( tendinitis), 20 mg triamcinolone (frozen shoulder) or a mixture of procaine and triaminolone (bursitis). The treatment was given to the affected part only. Nearly all of these patients were rapidly relieved of their symptoms to their satisfaction.

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