Subacromial Ultrasound-guided or Systemic Steroid Injection for Rotator Cuff Disease, a Randomized Double Blinded Study

Inclusion Criteria: * above 18 years * shoulder pain for more than 3 months * pain at abduction of the affected shoulder * less than 50 % reduced passive glenohumeral range of motion in no more than one direction of either abduction, external or internal rotation * 2 of 3 positive isometric test of external rotation, internal rotation and abduction * positive Hawkins-Kennedy impingement test Exclusion Criteria: * SPADI score below 30 points * symptomatic acromioclavicular arthritis * clinical and radiological findings indicating glenohumeral joint pathology * referred pain from neck or internal organs * clinical signs of a cervical syndrome * generalized muscular pain syndrome with bilateral muscular pain in the neck and shoulders * history of inflammatory arthritis * diabetes mellitus type 1 * contraindications to local steroid or lidocaine hydrochloride injections * corticosteroid injections last month before inclusion * unable to respond to questionnaires