Corticosteroid injection for rotator cuff disease

doi:10.1136/bmj.a2599

Published 23 January 2009, doi:10.1136/bmj.a2599
Cite this as: BMJ 2009;338:a2599

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Corticosteroid injection for rotator cuff disease

Systemic injection of corticosteroid is as effective as localinjection

The first 150 words of the full text of this article appear below.

In the linked randomised controlled trial (doi:10.1136/bmj.a3112),Ekeberg and colleagues compare the effectiveness of ultrasoundguided corticosteroid injection in the subacromial bursa withsystemic corticosteroid injection in people with rotator cuffdisease.¹ They found no significant difference in pain and disabilitybetween the two groups after six weeks. This suggests that theexact location of corticosteroid injections is not important.

The diagnosis of patients with shoulder pain can be difficult.²This is illustrated by Ekeberg and colleagues’ study,in which general practitioners referred patients with suspectedrotator cuff disease to an outpatient clinic, and those withconfirmed disease were entered into the study. They referred312 patients, but 140 were subsequently excluded because theyhad other diagnoses.¹ Rotator cuff disease is diagnosed in upto 70% of people with shoulder pain.³

The optimal management of shoulder pain is still debated. Oneof the available treatments is injection with . . . [Full text of this article]

Bart W Koes, professor of general practice

¹ University Medical Center Rotterdam, Department of General Practice, PO Box 2040, 3000 CA Rotterdam, Netherlands

b.koes@erasmusmc.nl

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