J Korean Radiol Soc.  2001 Jul;45(1):55-59. 10.3348/jkrs.2001.45.1.55.

Adhesive Capsulitis of the Shoulder: MR Arthrography

• Kim HJ
• Han TI
• Lee KW
• Kwon ST
• Choi YS
• Kim DH
• Han HY
• Song MK

• KMID: 2200398
• DOI: http://doi.org/10.3348/jkrs.2001.45.1.55

Abstract

PURPOSE: Adhesive capsulitis is a clinical syndrome involving pain and decreased joint motion caused by thickening and contraction of the joint capsule. The purpose of this study is to describe the MR arthrographic findings of this syndrome.
MATERIALS AND METHODS
Twenty-nine sets of MR arthrographic images were included in the study. Fourteen patients had adhesive capsulitis diagnosed by physical examination and arthrography, and their MR arthrographic findings were compared with those of 15 subjects in the control group. The images were retrospectively reviewed with specific attention to the thickness of the joint capsule, volume of the axillary pouch (length, width, height(depth)), thickness of the coracohumeral ligament, presence of extra-articular contrast extravasation, and contrast filling of the subcoracoid bursa.
RESULTS
Mean capsular thickness measured at the inferior portion of the axillary pouch was 4.1 mm in patients with adhesive capsulitis and 1.5 mm in the control group. The mean width of the axillary pouch was 2.5 mm in patients and 9.5 mm in controls. In patients, the capsule was significantly thicker and the axillary pouch significantly narrower than in controls (p<0.05). Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch (sensitivity 93%, specificity 80%) and a pouch narrower than 3.5 mm (sensitivity 93%, specificity 100%) were useful criteria for the diagnosis of adhesive capsulitis. In patients with this condition, extra-articular contrast extravasation was noted in six patients (43%) and contrast filling of the subcoracoid bursa in three (21%).
CONCLUSION
The MR arthrographic findings of adhesive capsulitis are capsular thickening, a low-volume axillary pouch, extra-articular contrast extravasation, and contrast filling of the subcoracoid bursa. Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch and a pouch width of less than 3.5 mm are useful diagnostic imaging characteristics.

Keyword

Magnetic resonance(MR), arthrography; Shoulder, arthrography; Shoulder, MR

MeSH Terms

Adhesives*
Arthrography*
Bursitis*
Diagnosis
Diagnostic Imaging
Humans
Joint Capsule
Joints
Ligaments
Physical Examination
Retrospective Studies
Sensitivity and Specificity
Shoulder*
Adhesives