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Introduction.Peri-articular shoulder pathology treatment may represent a challenge in patients with concomitant diabetes mellitus, high blood pressure and secondary kidney involvment. Systemic pain killers like analgetics or non-steroidal antiinflammatory drugs may have temporary contraindication. Indeed, corticosteroid peri-articular therapy may be contraindicated or may expose to undesired side effects. Hyaluronic acid derivates may represent a feasible alternative in these patients. Objectives. To determine corticosteroid versus Hyaluronate derivates subacromial subdeltoid bursa injection short term efficacy and security profile. Material and methods. Ten consecutive patients with diabetes mellitus, high blood pressure and symptomatic, ultrasound proven periarticular shoulder pathology underwent either subacromial subdeltiodian intrabursa corticosteroid (5 patients) or Hyaluronate derivate (5 patients) injection. Clinical pain reduction and functional outcome was evaluated at baseline and during 2 months follow up. Glucose blood levels and blood pressure values were analyzed in the 5 consecutive days after the interventional maneuver. Results. There was a trend in obtaining a quicker clinical response (pain reduction and range of motion improvement) to corticosteroid therapy in comparison with hyaluronate but with similar, significant results for the two therapies at 2 months (p<0.005).Glucose levels in patients treated with HA registered a decrease in the next 5 days of follow up. On the contrary, in the CS patient group, glucose levels increased in the next 5 days in all 5 patients, with a trend to reach the baseline levels at the end of the fifth day. Systolic and diastolic pressure values increased dramatically in the first 48 hours in the CS patients group (100%) in comparison to the HA patients group (100%) where both values decreased after the interventional maneuver. Conclusion. HA periarticular injection may represent a feasible therapy alternative in shoulder peri-articular pathology for patients with HBP and diabetes mellitus.

CORTICOSTEROID VERSUS VISCOSUPPLEMENTATION AGENTS PERIARTICULAR SHOULDER INJECTION- SHORT TERM EFFICACY AND SECURITY PROFILE - PILOT STUDY