Abstract / Summary
Background: The current diagnostic paradigm for clinically suspected subacromial bursitis is based on clinical history and physical examination. However, clinical signs frequently overlap with other pathologies. This study investigated short-term outcomes following the currently employed clinical criteria by comparing patients who met these criteria and received an injection with those who were offered but refused an injection. Methods: From July 2024 to April 2025, patients with symptoms of clinically suspected subacromial bursitis were enrolled and offered a corticosteroid injection. Patients were grouped based on whether they agreed to and received an injection or not. Range of motion (ROM) and patient-reported outcomes (PROs) were collected at the initial visit and Visual Analog Scale (VAS), Single Assessment Numeric Evaluation (SANE), and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores were collected using questionnaires emailed 2 weeks after the initial visit. This was a prospective, non-randomized observational study with treatment determined by patient preference. VAS and DASH were the primary outcomes. Results: 98 patients were enrolled and 73 patients received a corticosteroid injection. Follow-up PROs were completed by 47 injection patients and 18 non-injected patients. For injection patients, VAS scores improved from 5.3 ± 2.5 to 3.8 ± 2.8 (p < 0.001), and DASH scores improved from 42.2 ± 17.7 to 27.0 ± 21.7 (p < 0.001). Patients without injection also improved in VAS (5.1 ± 2.7 to 3.9 ± 2.7, p = 0.015) and DASH scores (38.3 ± 23.8 to 27.0 ± 18.8, p = 0.006). Between-group differences in changes in VAS, DASH, and affected-side SANE scores were not statistically significant (p = 0.661, p = 0.405, and p = 0.512, respectively). Conclusions: No statistically significant differences in pain or affected-shoulder function between groups were detected at approximately 2 weeks in this small, non-randomized study. These findings do not establish equivalence or determine whether clinical criteria identify patients who benefit from injection. Further studies should assess whether clinical and imaging findings improve patient selection.