CRITICAL REVIEW Corticosteroid Injections for Adhesive Capsulitis: A Review Ryan C. Xiao, BS,* Kempland C. Walley, BS,† Joseph P. DeAngelis, MD, MBA,‡ and Arun J. Ramappa, MD‡ Objective: Adhesive capsulitis is a self-limiting condition in a majority of patients and is often treated nonoperatively. However, symptoms may take 2 to 3 years to resolve fully. A small, but significant, portion of patients require surgical intervention. The purpose of this systematic review is to evaluate the efficacy of corticosteroid injections for the treatment of adhesive capsulitis (AC). Data Sources: A review of articles indexed by the United States National Library of Medicine was conducted by querying the PubMed database for studies involving participants with AC, frozen shoulder, stiff shoulder, or painful shoulder. Articles that included corticosteroids, glucocorticoids, steroids, and injections were included. Main Results: Corticosteroid injections provide significant symptom relief for 2 to 24 weeks. Injections can be performed intra-articularly or into the subacromial space. Evidence suggests that a 20 mg dose of triamcinolone may be as effective as a 40 mg injection. It remains unclear whether image-guided injections produce a clinically significant difference in outcomes when compared with landmark-guided (blind) injections. Corticosteroids may be less beneficial for diabetic patients. Patients using protease inhibitors (antiretroviral therapy) should not receive triamcinolone because the drug–drug interaction may result in iatrogenic Cushing syndrome. Conclusions: Corticosteroid injections for AC demonstrate short- term efficacy, but may not provide a long-term benefit. More high quality, prospective studies are needed to determine whether corticosteroid injections using ultrasound guidance significantly improve outcomes. Key Words: frozen shoulder, adhesive capsulitis, periarthritis, corticosteroid, injection (Clin J Sport Med 2017;27:308–320) KEY POINTS Corticosteroid injections provide short-term symptomatic relief for adhesive capsulitis (AC). Corticosteroid can be administered intra-articularly or through subacromial injection with equal efficacy. It is unclear whether ultrasound-guided injections are more effective than landmark-guided (blind) injections. Corticosteroid injections can raise blood glucose levels in diabetic patients. Triamcinolone injections can result in Cushing syndrome in patients on protease inhibitors (ritonavir/norvir). INTRODUCTION Adhesive capsulitis is a common condition in which the shoulder loses passive and active range of motion (ROM). Although the impairment is typically self-limited, the disease remains poorly understood and residual symptoms may persist for years. Conservative treatment of AC may involve one, or more, injections of corticosteroid. This review aims to evaluate the effectiveness of corticosteroid injections in terms of their effect on the disease’s duration and completeness of recovery. METHODS A review of articles indexed by the United States National Library of Medicine was conducted by querying the PubMed database for studies involving participants with AC, frozen shoulder, stiff shoulder, or painful shoulder. Articles that included corticosteroids, glucocorticoids, steroids, and injections were included. Additional references were re- viewed from the bibliographies of the retrieved articles. Expert opinion and review articles were excluded. Studies without control or comparison groups were excluded. Studies comparing corticosteroid injections to operative procedures were excluded. Comparisons to physical therapy were included as physical therapy or home exercises often accompany corticosteroid injections as standard of care. Using this review strategy (Figure), 16 studies met the inclu- sion criteria. Data items extracted from each study included: study design, study population, intervention, single or multiple Submitted for publication July 28, 2015; accepted April 19, 2016. From the *Harvard Medical School, Brookline, Massachusetts; †Depart- ment of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and ‡Department of Orthopaedics, Beth Israel Deacon- ess Medical Center, Harvard Medical School, Boston, Massachusetts. The authors report no conflicts of interest. Corresponding Author: Ryan C. Xiao, BS, Beth Israel Deaconess Medical Center, Boston, MA 02215 (ryan_xiao@hms.harvard.edu). Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. 308 Clin J Sport Med  Volume 27, Number 3, May 2017 Copyright Ó 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.