Combined Corticosteroid With Low Volume Compared to High Volume in Impingement Syndrome

Patients with rotator cuff impingement syndrome were randomized to undergo subacromial injection with 10mL total volume of 1% lidocaine plus 40mg triamcinolone acetonide (n = 22), or a 4mL total volume of 1% lidocaine plus 40-mg triamcinolone acetonide (n = 23). Evaluations using a visual analog scale (VAS) for pain during motion, and the Western Ontario Rotator Cuff Index (WORC) were completed before treatment and 30 minutes, 2 weeks, and 8 weeks after injection.

Inclusion criteria

• participants with clinically diagnosed the rotator cuff impingement
• participants aged 20 years and older
• at least 1 month's duration
• pain of moderate to severe intensity, defined as a score of 5 or more points on a 10-cm visual analog scale (VAS) rated from 0 (no pain) to 10 (worst imaginable pain)

Exclusion criteria

• patients with adhesive capsulitis of the shoulder (normal radiograph of affected shoulder, and restriction of passive motion >30° in ≥2 planes of movement)
• previous trauma history at currently affected shoulder
• previous corticosteroid injection history at the affected shoulder
• abnormal calcification and/or primary osteoarthritis of the shoulder joint on plain radiographs
• use of medication such as antiplatelet agent or anticoagulation.