Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool?

Abstract

Objective: To determine the accessibility of the coracohumeral ligament (CHL) by ultrasound (US) and to determine CHL thickness in adhesive capsulitis of the shoulder.

Design and patients: US examinations were carried out in 498 consecutive shoulders of 306 individuals (194 women and 112 men), mean age 47.4 years (range 15-92 years), in order to identify and measure the maximum thickness of the CHL. The patients were divided into three study groups: asymptomatic shoulders (n=121), painful shoulders (n=360) and shoulders with arthrographic evidence of adhesive capsulitis (n=17). The mean maximal thickness of CHL was compared among the 3 study groups (non-parametric test of Kruskal-Wallis, p<0.05).

Results: The CHL was visualized in 92 out of 121 shoulders in the asymptomatic group (76.0%), in 227 out of 360 shoulders in the painful shoulder group (63.0%), and in 15 out of 17 shoulders in the adhesive capsulitis group (88.2%). The average thickness of the CHL was significantly greater in adhesive capsulitis (3 mm) than in the asymptomatic (1.34 mm) and painful (1.39 mm) shoulders. No significant difference was found between asymptomatic and painful shoulders.

Conclusion: CHL depiction can be achieved in a reasonable proportion of shoulders. A thickened CHL is suggestive of adhesive capsulitis. More studies are needed for clinical validation of these data.