(2017) 'Analysis of hydrodilatation as part of a combined service for sti shoulder.', Shoulder and elbow., 9 (3). pp. 169-177. Further information on publisher's website:https://doi.org/10.1177/1758573216687273Publisher's copyright statement:Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractObjectives: Adhesive capsulitis is a common cause of stiff shoulder and may result in pain and restriction of movement. The aim of this study was to investigate the role of hydrodilatation of the glenohumeral joint in the management of adhesive capsulitis.Methods: Patients referred from the shoulder clinic underwent hydrodilatation under ultrasound guidance. Of 209 referred for hydrodilatation, 163 underwent the procedure and attended follow-up physiotherapy. Outcome measures were available on 118 patients (58 men, 60 women). Mean age of the study group was 52.6 years.Results: There was a statistically significant improvement in both Oxford Shoulder Score (OSS) and Disability Arm Shoulder Hand Scores (Quick DASH) in the first four weeks after the procedure, which was maintained, but not improved to the end of the study period. Patients presenting with pain, those who had a history of steroid injections and older patients had worse functional scores at presentation. Diabetes (both Type I and II), previous physiotherapy, length of history and whether pain or stiffness or both were the predominant symptom did not have any statistical significance at presentation. These factors were not predictors of statistically significant improvement in functional scores.Conclusion: Hydrodilatation results in significant improvement of symptoms in patients with adhesive capsulitis. Article focusA combined service for managing the stiff shoulder using orthopaedics, physiotherapy and radiology was analysed using patient scoring systems. Key messages1. Hydrodilatation under ultrasound guidance is an effective treatment for the stiff shoulder. 2 Strengths and limitations1. Hydrodilatation is a minimally invasive procedure for the management of the nonarthritic stiff shoulder. 2. The procedure well tolerated. 3. The multi-disciplinary team, (MDT), of orthopaedic surgeons, physiotherapists and radiologists functioned well in our institution 4. Loss to follow-up limited the size of our trial cohort.

This is the first known case of intradural involvement by tumoral calcinosis. This is an uncommon disorder, and a high index of suspicion is required to diagnose the condition, which can recur if incompletely removed.

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