Frozen Shoulder Hydrodilatation
Hydrodilatation (also known as distension arthrography) is a specialised ultrasound-guided procedure used to treat frozen shoulder (adhesive capsulitis). During the injection, a mixture of fluid is gently introduced into the shoulder joint capsule to stretch and expand the tight, inflamed tissue.
Frozen shoulder causes the capsule to become thickened, stiff, and inflamed. Hydrodilatation works by reducing this tightness, helping improve pain and restore movement.
Why Hydrodilatation Works
The procedure helps by:
Stretching and loosening the tight joint capsule
Reducing inflammation inside the shoulder
Restoring some of the joint’s natural space
Improving range of motion
Making physiotherapy exercises easier and less painful
Providing pain relief in the painful “freezing” and stiff “frozen” stages
Many patients notice early improvement in movement and further gains when combined with targeted physiotherapy.
Who Is Hydrodilatation Suitable For?
Hydrodilatation is most effective for:
Frozen shoulder (adhesive capsulitis) — early or established stages
Shoulder stiffness with significant capsular tightness
Painful loss of movement, particularly external rotation
People struggling to make progress with physiotherapy alone
Patients wanting a non-surgical treatment option
It is particularly useful when pain and stiffness limit everyday activities such as dressing, reaching overhead, driving, or sleeping.
What Happens During the Procedure?
The injection typically includes:
Local anaesthetic for comfort
Saline to gently stretch the capsule
Corticosteroid to reduce inflammation
As the capsule expands, patients often feel a sense of pressure followed by a reduction in stiffness.
After the procedure, guided exercises help maintain and improve the increased range.
Why Ultrasound Guidance Is Important
Ultrasound ensures the injection is delivered precisely into the shoulder joint, which is essential for hydrodilatation to be effective. Real-time imaging allows:
Accurate needle placement inside the joint space
Safe and controlled delivery of the fluid
Monitoring of capsular expansion
Avoidance of nerves, blood vessels, and tendons
Improved patient comfort and confidence
Ultrasound guidance significantly increases the success rate of this procedure compared with landmark-guided injections.