Evaluating Correlations of Coracohumeral Ligament Thickness with Restricted Shoulder Range of Motion and Clinical Duration of Adhesive Capsulitis with Ultrasound Measurements

Abstract

Objectives The primary objective of this study is to evaluate, using ultrasound measurements, the correlation between coracohumeral ligament (CHL) thickness and restricted shoulder range of motion (ROM) in patients with adhesive capsulitis (AC). The secondary objective is to investigate the correlation between CHL thickness and disease duration. Design Prospective cross‐sectional survey. Setting Clinical research of a tertiary care hospital. Methods Overall, 65 patients with clinically diagnosed AC were enrolled. Ultrasound measurements of CHL thickness in the axial oblique plane were obtained under maximal external rotation of the glenohumeral joint. Both Shoulder Pain and Disability Index (SPADI) and shoulder ROM were prospectively evaluated by an experienced investigator. CHL thickness was compared with shoulder ROM and SPADI. The association between CHL thickness and disease duration was also investigated. Results Simple linear regression analysis showed significant inverse correlation between CHL thickness and shoulder ROM including external rotation (ER) (r = −0.335, P = .006) and internal rotation (IR) (r = −0.409, P = .001). CHL thickness also correlated with disease duration (r = −0.352, P = .004). Multiple linear regression analysis demonstrated that CHL thickness was significantly associated with restricted ER (r = −0.293, P = .02) and IR (r = −0.363, P = .003) after adjusting for age and disease duration. On the other hand, CHL thickness showed no significant correlation with abduction (r = −0.210, P = .09), flexion (r = −0.170, P = .176), or total SPADI score (r = 0.176, P = .16). Moreover, CHL was significantly thicker in patients with disease duration >6 months (P = .004, difference in means: 0.55 mm, 95% confidence interval: −0.922, −0.183). Conclusions CHL was significantly thicker in later‐stage AC. CHL thickness correlated negatively with ER and IR of the shoulder. Furthermore, CHL thickening could be observed in the early stage of the disease course. These imaging findings may assist in confirming the diagnosis of AC, leading to early intervention and treatment options.

A retrospective study of ultrasound-guided intervention for frozen shoulder in the frozen stage

“…Lu et al ( 23 ) found that US-guided distension of the shoulder joint cavity had good efficacy for the treatment of FS. However, in the frozen stage, CHL thickness correlates negatively with the Er and Ir ranges of the shoulder ( 14 ), and FS patients with thickening of the CHL do not achieve good improvement of shoulder ROM using this method alone ( 24 ). Many studies have shown that steroid drugs can effectively control pain associated with FS ( 25 ), but these drugs are relatively short acting ( 26 , 27 ).…”

“…When the CHL is thickened up to 3.0 mm, there is a high likelihood for the existence of FS. The thickening of the CHL is highly correlated with adhesions, inflammation, and stability of the shoulder joint ( 14 ). The CHL is stiffer in the frozen stage than in the freezing stage ( 24 ).…”

“…The injection was ended until the drug can flow in and out of the subacromial bursa to form a bar-shaped anechoic. When the thickness of the CHL exceeded 3 mm ( 14 ), the patient underwent an US-guided acupotomy (diameter: 0.6 mm, ZhongWu, Jiangsu, China) lysis of the CHL during the first treatment. The coracoid process of the CHL was longitudinally thinned and transversely striped by an acupotome three times under sonographic guidance ( Figure 3 ) ( 15 ).…”

What’s New in Rehabilitation Post Orthopaedic Trauma?

“…But satisfaction after nonoperative treatment of first CMC osteoarthritis is not yet optimal, positive expectations of treatment outcomes are associated with higher satisfaction. Therefore, optimizing patient expectations may further improve treatment expectations and outcomes [5,6]. In another systematic review and meta-analysis which included 11 RCTs, Marotta et al compared the effectiveness of 4 different orthoses (short thermoplastic CMC splint, long thermoplastic CMC-metacarpophalangeal [MCP] splint, short neoprene CMC splint, and long neoprene CMC-MCP splint) with that of no splinting for first CMC osteoarthritis.…”

Associação de sintomas ansiosos e depressivos em pacientes com capsulite adesiva

“…Magnetic resonance imaging (MRI) demonstrates a reduced axillary recess and thickening of the coracohumeral ligament, an important restrictor of external rotation. 1,2 Although primary adhesive capsulitis develops spontaneously, its etiology remains uncertain. Some associated factors were reported, including diabetes mellitus, thyroid diseases, breast cancer, hemiplegia, and trauma; shoulder surgery followed by immobilization can result in secondary adhesive capsulitis.…”