Adhesive capsulitis: role of MR imaging in differential diagnosis

Abstract

The purpose of this study was to describe and characterize the MR imaging findings in a group of patients who underwent surgery for adhesive capsulitis. Twenty-four MR imaging studies in 24 consecutive patients with clinical evidence of adhesive capsulitis were performed prior to arthroscopic capsulotomy. There were 17 women and 7 men with a mean age of 53.5 years. Images were scrutinised for changes in the synovium particularly in the rotator interval, around the biceps anchor and axillary pouch. Intravenous gadolinium was given routinely. We also examined a control group of 22 patients who underwent the same MR imaging protocol after referral for rotator cuff pathology. Soft tissue density showing variable enhancement after gadolinium administration was visible in the rotator interval in 22 of 24 studies on MR imaging. Seventeen patients showed soft tissue density partially encasing the biceps anchor. Ten patients showed thickening and gadolinium enhancement of the axillary pouch. Three patients from the study cohort had partial tears of the supraspinatus tendon. All the patients subsequently had surgery which confirmed fibrovascular scar tissue in the rotator interval, around the biceps anchor and a variable degree of synovial inflammation of the glenohumeral capsule. Two patients from a control group with suspected rotator cuff pathology showed abnormal intensity in the rotator interval on MR imaging. Magnetic resonance imaging can identify changes in the shoulder joint that correspond to abnormalities seen at surgery. This may be useful for discriminating adhesive capsulitis from other causes of shoulder pain.

Magnetic Resonance Imaging of Adhesive Capsulitis: Correlation with Clinical Staging

“…Connell et al described a series of 24 patients, all of whom underwent arthroscopic capsulotomy [10]. All patients were evaluated with indirect MRI arthrography.…”

“…The arthrographic criteria of adhesive capsulitis include the following: limited injectable fluid capacity of the glenohumeral joint (7-10cc), a small dependent axillary fold, and irregularity of the anterior capsular insertion at the anatomic neck of the humerus [8,9]. More recently, MRI features helpful in the diagnosis of AC have been described in the literature, with relatively disappointing overall specificity for the disease [10][11][12][13]. Most of these reports have included MRI images obtained with either indirect (intravenous) or direct (intraarticular) arthrography [14][15][16].…”

Magnetic resonance imaging of shoulders with idiopathic adhesive capsulitis: reliability of measures

“…Tamai and Yamamoto [8], using dynamic MRI, showed that the synovial in AC differed from that in normal shoulders. Recently, Carrillon, Connell and coworkers reported that in patients with AC shoulders, Gd-chelate enhanced MRI of the joint capsule and synovial membrane in the axillary recess and rotator interval [2,9]. In all these studies, results were compared with findings in contralateral shoulders with impingement syndrome.…”

The anterior glenohumeral joint capsule: macroscopic and MRI anatomy of the fasciculus obliquus or so-called ligamentum glenohumerale spirale

“…Direct MR arthrography has proven to be a useful method in the evaluation of the normal anatomy as well as pathologies of the shoulder joint [22,23,[29][30][31]. The enhanced soft tissue contrast and controlled distension of the joint cavity provides better delineation and assessment of the glenohumeral intra-articular structures.…”