Adhesive Capsulitis of the Shoulder: Current Concepts on the Diagnostic Work-Up and Evidence-Based Protocol for Radiological Evaluation

Abstract

Adhesive capsulitis is an idiopathic and disabling disorder characterized by intense shoulder pain and progressive limitation of active and passive glenohumeral joint range of motion. Although adhesive capsulitis has been traditionally considered a diagnosis of exclusion that can be established based on a suggestive medical history and the detection of supporting findings at the physical exam, imaging studies are commonly requested to confirm the diagnostic suspicion and to exclude other causes of shoulder pain. Indeed, clinical findings may be rather unspecific, and may overlap with diseases like calcific tendinitis, rotator cuff pathology, acromioclavicular or glenohumeral arthropathy, autoimmune disorders, and subacromial/subdeltoid bursitis. Magnetic resonance imaging, magnetic resonance arthrography, and high-resolution ultrasound have shown high sensitivity and accuracy in diagnosing adhesive capsulitis through the demonstration of specific pathological findings, including thickening of the joint capsule and of the coracohumeral ligament, fibrosis of the subcoracoid fat triangle, and extravasation of gadolinium outside the joint recesses. This narrative review provides an updated analysis of the current concepts on the role of imaging modalities in patients with adhesive capsulitis, with the final aim of proposing an evidence-based imaging protocol for the radiological evaluation of this condition.

The effect of platelet-rich plasma combined with arthroscopic release in the treatment of frozen shoulder

“…It was previously believed that the disease was self-limiting and often resolved within 1 to 2 years of onset. The present study revealed that 40% of patients continue to experience signi cant limitations in shoulder joint mobility even after 2 years, signi cantly impacting their daily activities [5].…”

“…Although frozen shoulder is a self-limiting condition, it has a prolonged course and causes signi cant pain, which greatly affects the daily lives of patients [5,24]. Early and effective treatment can reduce pain, shorten the duration of the disease, and enhance the quality of life for patients.…”

“…Early and effective treatment can reduce pain, shorten the duration of the disease, and enhance the quality of life for patients. Currently, there is no standardized treatment for frozen shoulder [5]. Typically, conservative treatment is the rst approach.…”

Can Secondary Adhesive Capsulitis Complicate Calcific Tendinitis of the Rotator Cuff? An Ultrasound Imaging Analysis

“…To the best of our knowledge, this is the first original research focused on assessing the diagnosis of secondary AC in patients with CT of the rotator cuff. Indeed, the association between CT of the rotator cuff and glenohumeral AC is reported even in recent review articles as a possible and not wholly understood association [22].…”

“…While according to the guidelines of the European Society of Musculoskeletal Radiology, a radiological diagnosis of AC can be made only with MRI [22], several studies have recently demonstrated the diagnostic reliability through correct US exams, evaluating the…”