Soler-Pérez, María AraceliSerrano-Córcoles, Maria del CarmenFerrer-Márquez, ManuelLópez-González, María del MarPérez-Sáez, Miguel ÁngelGarcía-Torrecillas, Juan Manuel2022-11-292022-11-292021-04-22Soler-Pérez MA, Serrano-Córcoles MDC, Ferrer-Márquez M, López-González MDM, Pérez-Sáez MÁ, García-Torrecillas JM. Evaluación del tratamiento con infiltraciones intraarticulares en la patología osteoarticular del hombro en atención primaria [Evaluation of treatment with intra-articular injections in osteoarticular pathology of the shoulder in primary care]. Aten Primaria. 2021 Aug-Sep;53(7):1020510212-6567http://hdl.handle.net/10668/4424Main objective To evaluate the clinical response at 24 weeks after injection, measured as pain relief and functional recovery, in painful shoulder syndrome (PSS) in primary care (PC). Design Longitudinal case series with injection treatment in the scapulohumeral joint, describing functionality and pain evolution before and at 24 weeks post injection. Location Non-urban primary care centres. Participants Patients with osteoarticular shoulder pathology susceptible to injection, failure of pharmacological treatment and rating on the visual analogue scale (VAS) ≥ 4 or constant score (CS) ≤ 70. Interventions Intra-articular injection of corticosteroid and local anaesthetic into the scapulohumeral joint, describing its evolution at 1, 4, 12 and 24 weeks post injection. Main measurements Infiltration response according to EVA before and after, CS before and after, number of infiltrations, side effects, temporary inability to work (TIL). Results Sixty-six patients receiving injection, mean age 51.1 years (SD 14.7), 57.6% were women and 63.3% were injection in the right shoulder. A 22.7% required TIL and were discharged with a median of 14 days (range 7-56 days). They required an injection (80.3%) and the most frequent injection pathology was rotator cuff tendinitis (90.9%). They suffered mild side effects (9.4%). We found a decrease in pain from severe to mild and a functional improvement from poor to good. The variables: being retired (OR: 37.82, P = .001) and having an EVA score prior to injection > 8 (OR: 15.67, P = .055, almost significant) were associated with poor response. Conclusions Intra-articular administration of corticosteroids in PSS reduces pain and provides functional improvement after the first week after injection, and is maintained in the long term. This allows a quick recovery to work after an injection at two weeks reducing recovery time by 50%, with few side effects.Objetivo principal Evaluar la respuesta clínica a las 24 semanas de la infiltración, medida como alivio del dolor y recuperación funcional, en el síndrome de hombro doloroso (SHD) en atención primaria (AP). Diseño Serie de casos longitudinal con tratamiento de inyección en la articulación escapulohumeral; se describen la funcionalidad y la evolución del dolor previa y a las 24 semanas postinfiltración. Emplazamiento Atención Primaria. Centro de salud no urbano. Participantes Pacientes con patología osteoarticular de hombro susceptible de infiltración, fracaso de tratamiento farmacológico y calificación en la escala analógica visual (EVA) ≥ 4 o Constant Score (CS) ≤ 70. Intervenciones Inyección intraarticular corticosteroide y anestésico local en la articulación escapulohumeral, describiendo su evolución a 1, 4, 12 y 24 semanas postinfiltración. Mediciones principales Respuesta de la infiltración según EVA antes-después, CS antes-después, número de infiltraciones, efectos secundarios, incapacidad laboral transitoria (ILT). Resultados Se infiltraron 66 pacientes, edad media 51,1 años (DE: 14,7), 57,6% mujeres, 63,3% infiltración hombro derecho. El 22,7% precisaron ILT y cursaron alta con una mediana de 14 días (rango de 7-56 días). Precisaron una infiltración (80,3%) y la patología infiltrada más frecuente fue la tendinitis de los rotadores (90,9%). Sufrieron efectos secundarios leves un 9,4%. Encontramos disminución de dolor de severo a leve y una mejoría funcional de pobre a buena. Las variables: ser jubilado (OR: 37,82, p = 0,001) y tener un puntaje EVA previo a la infiltración > 8 (OR; 15,67, p = 0,055, cuasi significativo) se asociaron a mala respuesta. Conclusiones La administración intraarticular de corticosteroides en el SHD disminuye el dolor y aporta una mejoría funcional tras la primera semana postinfiltración, manteniéndose a largo plazo. Esto permite una rápida incorporación laboral con una infiltración a las 2 semanas, disminuyendo en un 50% el tiempo de recuperación, con escasos efectos secundarios.spaAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Shoulder painIntra-articular injectionsPrimary careVisual analogue scaleShoulder Impingement SyndromeHombro dolorosoInyecciones intraarticularesDolor de hombroAtención primaria de saludEscala visual analógicaSíndrome de pinzamiento del hombroMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Routes::Injections::Injections, Intra-ArticularMedical Subject Headings::Persons::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health CareMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Range of Motion, ArticularMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment OutcomeMedical Subject Headings::Anatomy::Musculoskeletal System::Muscles::Muscle, Skeletal::Rotator CuffMedical Subject Headings::Anatomy::Body Regions::Extremities::Upper Extremity::ShoulderMedical Subject Headings::Persons::Persons::Age Groups::InfantMedical Subject Headings::Persons::Persons::Age Groups::Child::Child, PreschoolMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Pain::Shoulder PainMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Central Nervous System Depressants::Anesthetics::Anesthetics, LocalMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Visual Analog ScaleMedical Subject Headings::Technology and Food and Beverages::Technology, Industry, and Agriculture::Transportation::Aviation::Space Flight::Extravehicular ActivityMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization::Patient DischargeMedical Subject Headings::Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormonesresearch article33895613open access10.1016/j.aprim.2021.1020511578-1275PMC8093412