[Arthrography in the diagnosis and treatment of idiopathic adhesive capsulitis]

The painful shoulder--i.e., adhesive capsulitis--present two basic symptoms: painful and impaired motion. Clinics allow the diagnosis to be made, but treatment is difficult. In our opinion, shoulder arthrography is very useful to distinguish idiopathic from secondary capsulitis involving bones and joints: moreover, in the patients with adhesive capsulitis, arthrography is useful when removing adhesions by repeated forceful distensions of the joint capsule. January 1990 through December 1991, forty-five patients with adhesive capsulitis were studied with shoulder arthrography; 19 patients with primary adhesive capsulitis underwent forceful distension with lidocain and contrast medium and the intraarticular injection of 40 mg of triamcinolone enantate to eliminate local adhesions. Arthrographic brisement yielded good results: improved motion was observed in all patients, lasting 2 to 7 months. Forceful joint capsule distension is easy to perform and complication-free and yields valuable results; all of the above make the procedure advisable as a good alternative to surgery in primary adhesive capsulitis patients.