American Journal of Roentgenology, Vol 164, 1457-1459, Copyright © 1995 by American Roentgen Ray Society

ARTICLES

Adhesive capsulitis of the shoulder: MR diagnosis

EW Emig, ME Schweitzer, D Karasick and J Lubowitz
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

OBJECTIVE. Adhesive capsulitis is a clinical syndrome of pain and severely decreased joint motion ("frozen shoulder") caused by thickening and contraction of the joint capsule and synovium. Although arthrographic criteria for the diagnosis have been described, to our knowledge, the MR characteristics have not been reported. Accordingly, we studied the MR findings in 10 patients with this syndrome. MATERIALS AND METHODS. MR images of 25 subjects were included in the study. Nine had adhesive capsulitis documented by arthrography, and one had adhesive capsulitis proved at surgery. The MR findings in these patients were compared with those of 15 asymptomatic volunteers. Images were assessed for thickness of the joint capsule and synovium, for thickness of the coracohumeral ligament, and for volume of articular fluid. Capsule and synovium thickness was measured adjacent to the axillary recess. The volume of intraarticular fluid was calculated from direct measurements of the axillary recess and biceps tendon sheath. The rotator cuff interval was qualitatively evaluated for the presence of abnormal tissue. RESULTS. Thickening of capsule and synovium on MR images was characteristic of adhesive capsulitis, with a significant difference between mean thickness in patients with adhesive capsulitis (5.2 mm) and in asymptomatic volunteers (2.9 mm) (p < .01). Capsule and synovium thickness greater than 4 mm was a specific (95%) and sensitive (70%) criterion for the diagnosis of adhesive capsulitis. There was no significant difference in volume of articular fluid or thickness of the coracohumeral ligament between patients with adhesive capsulitis and asymptomatic volunteers (p > .5). The rotator cuff interval was not useful for assessing changes of adhesive capsulitis. CONCLUSION. Joint capsule and synovium thickness greater than 4 mm is a useful MR criterion for the diagnosis of adhesive capsulitis. The volume of articular fluid seen on MR images is not significantly diminished in patients with adhesive capsulitis.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				P. J Rundquist and P. M Ludewig Correlation of 3-Dimensional Shoulder Kinematics to Function in Subjects With Idiopathic Loss of Shoulder Range of Motion Physical Therapy, July 1, 2005; 85(7): 636 - 647. [Abstract] [Full Text] [PDF]

				T. G. Sanders and M. D. Miller A Systematic Approach to Magnetic Resonance Imaging Interpretation of Sports Medicine Injuries of the Shoulder Am. J. Sports Med., July 1, 2005; 33(7): 1088 - 1105. [Abstract] [Full Text] [PDF]

				B. Mengiardi, C. W. A. Pfirrmann, C. Gerber, J. Hodler, and M. Zanetti Frozen Shoulder: MR Arthrographic Findings Radiology, November 1, 2004; 233(2): 486 - 492. [Abstract] [Full Text] [PDF]

				B A de Jong, R Dahmen, J A Hogeweg, and R K Marti Intra-articular triamcinolone acetonide injection in patients with capsulitis of the shoulder: a comparative study of two dose regimens Clinical Rehabilitation, March 1, 1998; 12(3): 211 - 215. [Abstract] [PDF]