Ultrasound-Guided Hydrodilation for Chronic Fibro-Adhesive Subacromial Bursitis: A Pilot Study

Shoulder pain is a prevalent issue that often prompts patients to seek medical evaluation. Ultrasound (US) has become an indispensable tool in orthopedics, rheumatology, and rehabilitation for diagnosing musculoskeletal pain. One common cause of shoulder discomfort is subacromial chronic bursitis (SACB), characterized by the thickening of bursal walls and the fusion of synovial sheets, which impedes normal gliding motion in the subacromial space and results in pain. This study aimed to illustrate the ultrasound appearance of SACB and assess the effectiveness of ultrasound-guided hydrodilation as a treatment option. Patients diagnosed with SACB, defined by a bursal wall thickness greater than 1.5 mm, were recruited from an outpatient clinic. Participants were divided into two groups: one received ultrasound-guided hydrodilation, while the control group underwent a traditional blind injection of triamcinolone acetonide. Both groups followed the same rehabilitation program post-injection. Shoulder functionality was measured using the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) questionnaire at various time points: baseline, days 3, 7, 14, 30, 60, and 90. Results indicated a significant reduction in pain for both treatment groups, but notably, the hydrodilation group did not require re-treatment. These findings suggest that ultrasound-guided hydrodilation may be the preferred technique for treating SACB, as it effectively separates the bursal walls and alleviates patient symptoms with fewer invasive procedures. This approach not only enhances patient outcomes but also underscores the growing importance of ultrasound in managing shoulder conditions.