Letter to the Editor
Hydric distension of shoulder capsulitis
La distensión hídrica en las capsulitis de hombro
Moreen Meißner, Cayetano Alegre de Miquel
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Servicio de Reumatología, Hospital Universitario Dexeus-Quirón, Barcelona, Spain
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(b) The view of the rash of FCAS patient.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mustafa Çakan, Şerife Gül Karadağ, Nuray Aktay Ayaz" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Mustafa" "apellidos" => "Çakan" ] 1 => array:2 [ "nombre" => "Şerife Gül" "apellidos" => "Karadağ" ] 2 => array:2 [ "nombre" => "Nuray Aktay" "apellidos" => "Ayaz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574320301787?idApp=UINPBA00004M" "url" => "/21735743/0000001700000002/v1_202101301156/S2173574320301787/v1_202101301156/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hydric distension of shoulder capsulitis" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor,</span>" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "120" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Moreen Meißner, Cayetano Alegre de Miquel" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Moreen" "apellidos" => "Meißner" ] 1 => array:4 [ "nombre" => "Cayetano" "apellidos" => "Alegre de Miquel" "email" => array:1 [ 0 => "11120cam@comb.cat" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Reumatología, Hospital Universitario Dexeus-Quirón, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La distensión hídrica en las capsulitis de hombro" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hydric distention of the shoulder may be an inexpensive, non-surgical, alternative treatment for a painful shoulder and has been suggested in cases of capsulitis and/or involvement of the rotator cuff.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Shoulder capsulitis causes pain and limitation in active and passive movements; it is a disease which is recognised as one of the most painful and frequent of the musculoskeletal system, with an estimated prevalence of between 2% and 5%.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Common treatment options consist of physiotherapy, intra-articular injections and arthroscopic arthrolysis in prolonged cases.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Its physiopathology is not specifically known. This is an inflammatory process which develops adhesion and fibrosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> This fibrosis triggers a reduction of the capsular volume which may be corrected with the HD procedure.</p><p id="par0025" class="elsevierStylePara elsevierViewall">HD of the glenohumeral joint is performed with a saline solution (20−90 ml), together with steroids and local anaesthesia, injected under ultrasonographic control. The mechanical effect by the HD of the glenohumeral capsule reduces the distress on the painful receptors<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and also obtains an anti-inflammatory effect from the applied steroids. The adverse effects of the method involve trauma of the ligaments, blood vessels and nerves, septic arthritis and rupture of the capsule.</p><p id="par0030" class="elsevierStylePara elsevierViewall">We carried out a systematic search on Medline, found 2 recent meta-analysis<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> and 7 randomised and comparative clinical trials; these trials differed in several aspects such as the volume of saline solution injected, and the injection-associated drugs, and the number of injections given, which complicated the comparison of findings.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The main objectives in several cases focused on the mere HD procedure, whilst others attempted to address the capsule rupture.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Buchbinder et al., in a 2008 Cochrane review concluded that there is “silver level” proof of the benefits of HD for pain and range of movement in the short term and with no significant differences to steroid injections or physiotherapy.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In a meta-analysis of 2017 Wu et al. concluded that the efficacy of HD of the glenohumeral joint was similar to that of corticosteroid injections.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In another meta-analysis of 2018 that included 7 trials, Saltychev et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> found that there was insignificant efficacy of HD both in pain and mobility, concluding that the low benefit did not justify the procedure.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In a 2017 review where capsule rupture was sought Rymaruk and Peach concluded that this was a fast, non-surgical and cost-effective treatment which reduced pain and restored function, concluding that HD could be a first line treatment for a secondary care frozen shoulder, with capsule rupture being essential to achieve the benefit. This data has not been analysed in previous studies.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conclusion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The review of the different trials and meta-analysis shows that there is no proven benefit to be had between HD compared with other modes of treatment. HD under ultrasonographic control is an alternative in cases of capsulitis which do not respond to standard treatment.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conclusion" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Meißner M, Alegre de Miquel C. La distensión hídrica en las capsulitis de hombro. Reumatol Clin. 2021;17:120.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indications for hydrodilatation for frozen shoulder" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Rymaruk" 1 => "C. Peach" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1302/2058-5241.2.160061" "Revista" => array:7 [ "tituloSerie" => "EFORT Open Rev" "fecha" => "2017" "volumen" => "2" "numero" => "11" "paginaInicial" => "462" "paginaFinal" => "468" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29218231" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dolor articular en miembro superior" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. 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"fecha" => "2018" "paginaInicial" => "1" "paginaFinal" => "9" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arthrographic distension for adhesive capsulitis (frozen shoulder)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Buchbinder" 1 => "S. Green" 2 => "Y. Jm" 3 => "J. Rv" 4 => "M. Cumpston" 5 => "R. Buchbinder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD007005" "Revista" => array:5 [ "tituloSerie" => "Cochrane Database Syst Rev." 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