Background: Intra-articular corticosteroid injection is a commonly used therapy for adhesive capsulitis, but there are only few studies that compare the efficacy of corticosteroids according to different doses. Purpose: To determine whether intra-articular injections with a high-dose corticosteroid improves pain and function in patients with adhesive capsulitis better than a low dose or a placebo. Study Design: Randomized controlled clinical trial; Level of evidence, 1. Methods: Participants (n = 53) with primary adhesive capsulitis in the freezing stage were randomly assigned to receive ultrasound-guided intra-articular injections with 40 mg triamcinolone acetonide (high-dose group, n = 20), 20 mg triamcinolone acetonide (low-dose group, n = 20), or placebo (n = 13). After a single injection, participants were all instructed to carry out a home exercise program. The outcome measures included the Shoulder Pain and Disability Index (SPADI), visual analog scale (VAS) for average shoulder pain level, and passive range of motion including flexion, abduction, extension, external rotation, and internal rotation before treatment and at weeks 1, 3, 6, and 12 after treatment. Results: There were no significant differences in demographic and clinical characteristics at baseline between the 3 groups. Repeated-measures analysis of variance and post hoc tests showed improvement in SPADI and VAS scores and in flexion, abduction, and internal rotation especially for the low- and high-dose groups compared with the placebo. Yet, no significant difference was found between the 2 different corticosteroid dose groups. Conclusion: We assessed the efficacy of corticosteroid injections according to 2 different doses that are most widely used in intra-articular injections for adhesive capsulitis. This study shows that there were no significant differences between the high- and low-dose corticosteroid groups, indicating the preferred use of a low dose in the initial stage.

OBJECTIVE. The purpose of this study was to show the usefulness of dynamic contrast-enhanced MRI (DCE-MRI) and to determine the optimal time window in MRI for differentiating between septic arthritis and transient synovitis in painful hip joints. MATERIALS AND METHODS. Eighteen patients who underwent DCE-MRI were enrolled, and the final diagnoses were septic arthritis (n = 7) and transient synovitis (n = 11). The enhancement patterns of DCE-MRI were dichotomized according to the shape of the time–signal intensity curves. The time at the maximal difference in the signal intensity between two time–signal intensity curves of both femoral heads was recorded. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Receiver operating characteristic curves were calculated. RESULTS. Six of seven patients with septic arthritis in the hip joint had decreased enhancement during the early phase of DCE-MRI. The enhancement difference between the two patient groups ...