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Background <p>The aim of this study was to determine whether the efficacy of high-volume, ultrasound-guided subacromial injection with corticosteroid (CS) diluted with normal saline is superior to that of low-volume injection in patients with subacromial impingement syndrome (SIS).</p> Methods <p>This study included 70 patients diagnosed with SIS. Patients were randomized into either the high-volume CS injection group [1&#xa0;mL, 40&#xa0;mg triamcinolone acetonide (TA); 1&#xa0;mL, 2% lidocaine; 8&#xa0;mL normal saline mixture] or the low-volume CS injection group (1&#xa0;mL, 40&#xa0;mg TA; 1&#xa0;mL, 2% lidocaine; 1&#xa0;mL normal saline mixture). Additional instructions for a home exercise program were provided after the injection. Assessments were made at baseline and 4- and 12-weeks post-injection, using the following measurements: Shoulder Pain and Disability Index (primary outcome); visual analogue scale (pain); active range of motion measurements (abduction, flexion, and external and internal rotations); and Western Ontario Rotator Cuff Index.</p> Results <p>There were no significant differences between the groups in terms of demographic or shoulder-pain–related data at baseline. Both groups showed significant improvements in all outcomes at 4- and 12-weeks post-injection. However, there was no significant difference between the groups for any outcome. Post-injection adverse events and drug consumption during follow-up were comparable between the groups.</p> Conclusions <p>All outcome measures significantly improved in both the high- and low-volume injection groups, with no significant between-group differences. This suggests that high-volume CS injections provide no additional benefit over low-volume injections for reducing pain and improving function in patients with SIS.</p> Graphical Abstract <p></p>

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Effectiveness of High-Volume Corticosteroid Injection Diluted with Saline in Subacromial Impingement Syndrome: A Randomized Trial

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Rıdvan Yıldızhan,
  • İsa Cüce,
  • Enes Veziroğlu,
  • Taha Furkan Çakır,
  • Merve Başol Göksülük

摘要

Background

The aim of this study was to determine whether the efficacy of high-volume, ultrasound-guided subacromial injection with corticosteroid (CS) diluted with normal saline is superior to that of low-volume injection in patients with subacromial impingement syndrome (SIS).

Methods

This study included 70 patients diagnosed with SIS. Patients were randomized into either the high-volume CS injection group [1 mL, 40 mg triamcinolone acetonide (TA); 1 mL, 2% lidocaine; 8 mL normal saline mixture] or the low-volume CS injection group (1 mL, 40 mg TA; 1 mL, 2% lidocaine; 1 mL normal saline mixture). Additional instructions for a home exercise program were provided after the injection. Assessments were made at baseline and 4- and 12-weeks post-injection, using the following measurements: Shoulder Pain and Disability Index (primary outcome); visual analogue scale (pain); active range of motion measurements (abduction, flexion, and external and internal rotations); and Western Ontario Rotator Cuff Index.

Results

There were no significant differences between the groups in terms of demographic or shoulder-pain–related data at baseline. Both groups showed significant improvements in all outcomes at 4- and 12-weeks post-injection. However, there was no significant difference between the groups for any outcome. Post-injection adverse events and drug consumption during follow-up were comparable between the groups.

Conclusions

All outcome measures significantly improved in both the high- and low-volume injection groups, with no significant between-group differences. This suggests that high-volume CS injections provide no additional benefit over low-volume injections for reducing pain and improving function in patients with SIS.

Graphical Abstract