Correlations between clinical features and MRI findings in early adhesive capsulitis of the shoulder: a retrospective observational study

Abstract

Background: This retrospective study investigated the association between clinical features and MRI findings in patients with early adhesive capsulitis of the shoulder.

Methods: The study included 29 patients with early adhesive capsulitis of the shoulder. The clinical diagnostic criteria were significantly restricted passive range of motion (ROM) and a symptom duration of up to 9 months. Various measurements related to adhesive capsulitis, including humeral and glenoid capsular thickness in the axillary recess, maximal axillary capsular thickness, coracohumeral ligament thickness, and anterior capsular thickness were measured on MRI. Abnormal humeral and glenoid capsular hyperintensity in the axillary recess, abnormal hyperintensity in the rotator interval, and obliteration of the subcoracoid fat triangle were also evaluated. Correlations between MRI findings and clinical features, including limited ROM, pain, and symptom duration were sought.

Results: Maximal axillary and humeral capsular thickness measured on MRI were negatively correlated with ROM for internal rotation. Also, hyperintensity in axillary recess and glenoid capule were correlated with ROM for abduction. Humeral capsular hyperintensity was correlated with ROM for forward flexion. There were no MRI findings that showed correlations with ROM for external rotation and severity of pain. The hyperintensity in the humeral capsule among MRI findings was only correlated with duration of symptoms.

Conclusions: MRI can be useful for assessment of several measures of clinical impairment in patients with adhesive capsulitis. Thickening and hyperintensity of the joint capsule in the axillary recess on MRI is associated with limited ROM and duration of symptoms.

Keywords: Adhesive capsulitis; Magnetic resonance imaging; Range of motion; Shoulder; pain.

Fig. 1

Examples of findings on magnetic resonance images for a 48-year-old woman with adhesive capsulitis. a. Oblique coronal fat-suppressed T2-weighted image showing measurement of the thickest portion of the axillary joint capsule in both humeral (arrow) and glenoid (dashed arrow) attachment and also showing axillary capsular thickening and abnormal hyperintensity (arrow heads). Increased thickness was present only at the glenoid portion (6.23 mm); thickness was normal at the humeral portion (2.81 mm). b Oblique sagittal T2-weighted image showing measurement of the coracohumeral ligament thickness (dashed arrow). c Axial fat-suppressed proton density image showing measurement of anterior capsular thickness (dashed arrow) below the subscapularis tendon. d Oblique coronal fat-suppressed T2-weighted image at the coracoid process level showing abnormal hyperintensity in the subcoracoid fat triangle (arrows). e Oblique sagittal T1-weighted image showing obliteration of the subcoracoid fat triangle (arrows)

Fig. 2

Scattergrams showing the relationships between the four directions of range of motion (ROM) and maximal axillary capsular thickness. Filled squares with dotted lines and filled triangles with dash-dot lines represent the scatter plots with trend lines for men and women, respectively. Bold black lines with statistical values are trend lines for all patients