Effects of joint distention in shoulder diseases

From 1982 to 1992 arthrography was performed in 3707 patients with painful shoulders to determine the role of the subscapular bursal obliteration in the pathogenesis of painful, stiff shoulders and to evaluate the effects of distention on the subscapular bursa. Three hundred thirty-nine patients were excluded from the study because of incomplete data, leaving 3368. There were 2391 male and 977 female patients; their average age was 39.2 years (range, 8-86 years). Obliteration was noted in 1156 patients (34.3%), and filling of the bursa was seen in 2212 patients (67.7%). Function was regained in 178 patients (5%) by fluid distention alone, and in 308 (8%) patients by additional forced motion. Thus, 486 shoulders (14%) underwent distention and mobilization successfully. The most effective motion was forced abduction and internal rotation. Four hundred fifteen subjects were evaluated clinically; immediate pain relief after distention and/or bursting of the subscapular bursa was noted in all. There was also a remarkable improvement in the range of motion in all subjects who underwent distention alone, or in combination with forced mobilization.