Hydrodilatation
Encyclopedia
Hydrodilatation or hydraulic arthrographic capsular distension or distension arthrography is a medical treatment for adhesive capsulitis of shoulder. The treatment is applied by a radiologist assisted by a radiographer. Contrast medium
, a local anaesthetic and cortisone
are injected
into the joint. Then up to 40ml of sterile saline solution are injected, using X-ray
as guidance, to stretch the joint capsule
. Risk of complications is low. Whether the treatment is successful is known after a couple of weeks.
The procedure is performed under imaging guidance, using either fluoroscopy, ultrasound
or Computed Tomography (CT)
. Hydrodilatation is felt to provide benefit via two mechanisms: manual stretching of the capsule and thus disruption of adhesions
which are characteristic of adhesive capsulitis, and; the introduction of cortisone
provides a potent anti-inflammatory effect and thus prevents further adhesion recurrence.
Research in 2008 has questioned the benefit of hydrodilatation as giving no statistical benefit over injecting cortisone alone.
Contrast medium
A medical contrast medium is a substance used to enhance the contrast of structures or fluids within the body in medical imaging...
, a local anaesthetic and cortisone
Cortisone
Cortisone is a steroid hormone. It is one of the main hormones released by the adrenal gland in response to stress. In chemical structure, it is a corticosteroid closely related to corticosterone. It is used to treat a variety of ailments and can be administered intravenously, orally,...
are injected
Injection (medicine)
An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...
into the joint. Then up to 40ml of sterile saline solution are injected, using X-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
as guidance, to stretch the joint capsule
Joint capsule
An articular capsule is an envelope surrounding a synovial joint.-Layers:Each capsule consists of two layers:* an outer layer composed of avascular white fibrous tissue...
. Risk of complications is low. Whether the treatment is successful is known after a couple of weeks.
The procedure is performed under imaging guidance, using either fluoroscopy, ultrasound
Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
or Computed Tomography (CT)
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
. Hydrodilatation is felt to provide benefit via two mechanisms: manual stretching of the capsule and thus disruption of adhesions
Adhesion (medicine)
Adhesions are fibrous bands that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connect tissues not normally connected.-Pathophysiology:...
which are characteristic of adhesive capsulitis, and; the introduction of cortisone
Cortisone
Cortisone is a steroid hormone. It is one of the main hormones released by the adrenal gland in response to stress. In chemical structure, it is a corticosteroid closely related to corticosterone. It is used to treat a variety of ailments and can be administered intravenously, orally,...
provides a potent anti-inflammatory effect and thus prevents further adhesion recurrence.
Research in 2008 has questioned the benefit of hydrodilatation as giving no statistical benefit over injecting cortisone alone.