Do the Findings of Magnetic Resonance Imaging, Arthrography, and Ultrasonography Reflect Clinical Impairment in Patients With Idiopathic Adhesive Capsulitis of the Shoulder?

Abstract

Objective: To investigate the correlation between arthrography, magnetic resonance imaging (MRI), and ultrasonography (US) findings in patients with idiopathic adhesive capsulitis (IAC) of the shoulder and their clinical presentation as well as functional impairment.

Design: Cross-sectional observational study.

Setting: Institutional practice.

Participants: Patients (N=75) with a clinical diagnosis of unilateral IAC.

Interventions: Contrast-enhanced MRI, single-contrast arthrography, and US were performed in all patients.

Main outcome measures: The thickness of the axillary recess, coracohumeral ligament (CHL), and enhanced portion in the rotator cuff interval was measured using MRI. Arthrography was used to calculate the total score of shoulder arthrographic criteria. US was used to measure the thickness of the inferior glenohumeral ligament (IGHL) and CHL, and the IGHL ratio and CHL ratio were calculated by comparing those of the unaffected side.

Results: None of the MRI parameters was correlated with clinical assessment scores. The total score of shoulder arthrographic criteria was negatively correlated with passive range of motion of the total shoulder motion (P<.05), shoulder forward flexion (P<.05), and abduction (P<.05). The total Constant-Murley score was well correlated with the total score of shoulder arthrographic criteria (P<.05). The total shoulder joint space capacity was positively correlated with passive range of motion of the total shoulder motion (P<.05) and shoulder forward flexion (P<.05). The IGHL thickness, IGHL ratio, CHL thickness, and CHL ratio were negatively correlated with shoulder external rotation (P<.05).

Conclusions: The findings of arthrography and US in patients with IAC of the shoulder were correlated with clinical assessment scores, whereas all measuring parameters on MRI were not. US is recommended as the preferred option for diagnosing IAC of the shoulder because it is noninvasive, reflects the clinical features of IAC, and provides anatomical accuracy.

Keywords: Arthrography; Magnetic resonance imaging; Rehabilitation; Ultrasonography.