Shoulder distension arthrography

Shoulder distension arthrography is available privately at The Edinburgh Clinic Shoulder Service for the treatment of frozen shoulder. Enjoy fast access to appointments with specialists within the calming, unique and quality clinical environment at The Edinburgh Clinic.

What happens during the procedure?

  • You will be asked to lie on a treatment table.
  • You will be awake during treatment, with the treatment area numbed using an injection of local anaesthetic.
  • A needle will be inserted into your shoulder joint, and low dose X-rays will be used to help your consultant radiologist guide the needle into the correct position.
  • When correct needle position has been confirmed, a combination of local anaesthetic, steroids, saline (salty water) and gas will be injected into the joint. This injection stretches and tears the thickened capsule to allow much improved shoulder movement.
  • After a few days the steroid will start to work on reducing inflammation reducing, or eliminating your shoulder pain.

What are the side effects?

  • Steroid can cause irritation following injection, creating the so-called ‘flare response’.
  • You may find your shoulder is more painful than it was for two or three days following treatment.
  • With any injection into a joint there is a risk of infection. This risk is greatly minimised however, as the injection is done under ‘sterile’ conditions.
  • Some of the steroid will travel around the body to other tissues and makes insulin work less well for this short period of time. Patients with diabetes must monitor their sugar levels for up to two weeks after the injection.

How successful is the treatment?

In a recent audit of 50 patients (NHS Lothian) undergoing hydrodilatation SDA, results showed a significant improvement in post-procedure shoulder pain and motion:

  • All shoulder movements improved significantly after two days and by even more by four weeks (41 degrees flexion, 55 degrees abduction and 20 degrees external rotation at one month).
  • Shoulder function measured by the Oxford Shoulder Score improved significantly (up by 14 points after one month).
  • Pain improved by an average of 30%.
  • The improvements in movement, function and pain were best in those with the stiffest shoulders before the distension arthrogram.
  • Diabetic and non-diabetic patients had the same outcome, although it is known that due to the severity of frozen shoulder in some patients a second distension arthrogram may be required.

Shoulder distension arthrography Consultants