Clinical Outcomes of Transcatheter Arterial Embolization for Adhesive Capsulitis Resistant to Conservative Treatment

Ultrasound Microflow Imaging Technology for Diagnosis of Adhesive Capsulitis of the Shoulder

“…Studies using contrast‐enhanced MRI, arthroscopic, and histologic observations revealed an abnormal increase in vascularity at the joint capsule in patients with adhesive capsulitis of the shoulder. An angiographic study investigating adhesive capsulitis also revealed abnormal vessels (most frequently at the rotator interval), indicating the key role of abnormal angiogenesis in the pathogenesis of adhesive capsulitis …”

“…Recently, the pathophysiologic mechanisms of adhesive capsulitis have been reported to be related to neovascularization and vascular endothelial growth factor; neovascularization precedes structural changes such as capsular thickening . Also, studies using conventional Doppler US, MRI, and surgical observation demonstrated that increased vascular flow in the rotator interval, subcoracoid fat triangle, and joint capsule plays an important role in the pathogenesis of early‐stage adhesive capsulitis of the shoulder .…”

Concordancia diagnóstica de capsulitis adhesiva por resonancia magnética entre centros de imagenología y una clínica de reconstrucción articular con correlación quirúrgica

“…1,3,14 La hidrodilatación o artrografía de distensión con medio de contraste o solución salina y corticosteroides, con resultados discutibles en mejoría a corto plazo de dolor y movimiento. 1,15 Existen otros tratamientos menos estudiados como crioterapia de cuerpo completo con terapia física, infiltración con toxina botulínica, 1 embolización arterial 16 o la terapia de ondas de choque con masaje miofascial en rango de 0.08 a 0.28 mJ/mm 2 y de 10 a 13 Hz en un rango de 400 a 500 ondas. 17 Entre las opciones de tratamiento quirúrgico tenemos la manipulación bajo anestesia y la capsulectomía artroscópica o abierta.…”

The Pain Crisis: Interventional Radiology's Role in Pain Management

“…Angiogenesis is known to contribute to chronic pain in osteoarthritis by enabling growth of new unmyelinated sensory nerves along their path [94]. Histopathological studies have demonstrated the existence of abnormal vessels accompanying nerve fibers in tissues from various painful conditions, including osteoarthritis [94] and frozen shoulder [95]. This is the premise for performing transcatheter arterial embolization around the knee (Fig.12) and shoulder using antibiotic agents (Imipenem/cilastatin sodium) [94] or permanent embolic microspheres (100-75 µm) [96].…”

“…This is the premise for performing transcatheter arterial embolization around the knee (Fig.12) and shoulder using antibiotic agents (Imipenem/cilastatin sodium) [94] or permanent embolic microspheres (100-75 µm) [96]. Imipenem/cilastatin sodium is an approved antibiotic and forms 10-70 µm insoluble particles when suspended in contrast, allowing for embolization of small vessels [94,97]. Some authors consider it to be safer than the conventional microsphere embolic agents [94,97]…”