Adhesive Capsulitis in the Elderly: Comparison of Magnetic Resonance Imaging Findings with Effectiveness of Hydrodilatation Treatment

Park, Young Sook; Park, Yun Hee

Abstract

BACKGROUND
Shoulder pain and disability are common problems in the elderly, and adhesive capsulitis is one of the main causes. To identify the characteristics of adhesive capsulitis in elderly patients, we compared magnetic resonance imaging (MRI) findings of treatment effect between two age groups.
METHODS
We enrolled 54 adult patients with adhesive capsulitis who underwent shoulder MRI and hydrodilatation treatment, and divided them into the elderly and the control groups. Capsular thickness in the axillary pouch, presence of subcoracoid fat obliteration in the rotator interval and accompanying lesions in the rotator cuff were evaluated on the shoulder MRI. The constant score and range of motion of the shoulder joints were measured three times-baseline, week 2, and week 12.
RESULTS
The elderly group showed significantly higher frequencies of subcoracoid fat obliteration (p=0.04) and rotator cuff lesion (p=0.003). Constant scores (p=0.006) and range of motion (forward flexion, p=0.012; external rotation, p=0.001; internal rotation, p=0.007) at week 12 were better in the control group. The control group showed significant increases in the scores at all 3 assessments (p<0.001), whereas the elderly group did not show significant improvement between weeks 2 and 12. Neither the elderly nor the control patients with rotator cuff tears showed a significant increase in the constant score at all 3 assessments.
CONCLUSION
Elderly patients showed more frequent rates of secondary adhesive capsulitis caused by rotator cuff injuries. Also, these rotator cuff injuries, especially tendon tears, might be related to a lack in long-term effect of hydrodilatation treatment.