Comparison between intraarticular triamcinolone acetonide and methylprednisolone acetate injections in treatment of frozen shoulder

OBJECTIVE: To compare the effectiveness of triamcinolone acetonide (40 mg) and methylprednisolone acetate (60 mg) in Iraqi patients with primary and secondary frozen shoulder.

METHODS: A total number of 135 (93 males and 42 females) patients with frozen shoulder, allocated at outpatient clinic of rheumatology in Al-Yarmook Teaching Hospital (Baghdad-Iraq) from January 2004 to December 2005, were enrolled in non-controlled clinical trial. The diagnosis of frozen shoulder was made using the guidelines for shoulder complaint issued by the Dutch College of General Practitioners. Intraarticular injections of 40 mg triamcinolone acetonide (46 males and 22 females) or 60 mg methylprednisolone acetate (47 males and 20 females) were given every 3 weeks (not more than 3 injections) by using posterior route.

RESULTS: Both triamcinolone acetonide (81.8%) and methylprednisolone acetate (83.3%) were equally effective in primary frozen shoulder. Triamcinolone acetonide is significantly improved diabetic frozen shoulder in comparison to methylprednisolone acetate (69% versus 39%). Also patients on triamcinolone acetonide required less number of steroid injections and higher percent of severe cases were significantly improved by triamcinolone acetonide in comparison with methylprednisolone acetate.

CONCLUSION: We conclude that triamcinolone acetonide is a good rescue for painful stiff shoulder particularly for resistant cases as with diabetes mellitus, and with long duration of illness. Also, its efficacy can be observed with less frequent injections.