Hydrodilatation is a procedure where a fine needle is placed into the shoulder joint and injection performed to stretch the joint capsule.

Capsulitis (also called adhesive capsulitis or frozen shoulder) is caused by inflammation of the lining of the shoulder capsule. It may be triggered by a minor injury or surgery and is more common in people with diabetes. The initial symptom is usually pain but stiffness often becomes chronic.

Procedure

Prior to treatment, an accurate diagnosis is essential which will usually require a diagnostic ultrasound or MRI scan. The ultrasound and injection can usually be done on the same day if your referrer has already discussed an injection with you.

The skin is cleaned with antiseptic and a fine needle is positioned into the joint using either xray or ultrasound guidance to ensure precise placement. If xray guidance is used a small amount of contrast dye will be injected. The joint is then distended with corticosteroid, local anaesthetic and sometimes sterile water, between 10 and 20mL in total.

Post Procedure Care

You should rest from any vigorous activity for 2 days. However in frozen shoulder, a programme of rehabilitation exercises is essential to consolidate improvement after the injection and restore your range of movement. This is best guided by your doctor or physiotherapist. An example given below is for general information only.

  1. Shoulder blade squeezes. Try to bring your shoulder blades together behind your back.
  2. Pendular exercises. Leaning forward supporting your good arm, swing your arm forwards and backwards then around in circles.
  3. Wall crawl. Stand in front of a wall and slowly “walk” up as high as you can.
  4. Hand to back. Put your hand in the middle of your back and then “walk” up as high as possible.
  5. Keeping your elbow in at your side and bent at 90 degrees, use something like a broom handle in the other hand to rotate the shoulder out as far as you can.

You should try to overcome stiffness but stop if pain increases.

Risks / Side Effects

There is a minimal risk of contrast reaction when performed using xray guidance. Any injection carries a small risk of introducing infection, about 1 in 30,000.

Before your Scan

It is a good idea to wear clothing that allows easy access to the area that is being imaged.

Duration

To be confirmed.