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. 2024 Jun 19;8(5):1033-1038.
doi: 10.1016/j.jseint.2024.06.004. eCollection 2024 Sep.

Inferior glenohumeral joint capsule thickness in frozen shoulder via ultrasonography

Toru Inada  1   2 , Masahiro Tsutsumi  3 , Masahiro Ikezu  3   4 , Yasuhiko Iizuka  5 , Tatsuo Nagano  2 , Shintarou Kudo  1   3   4
Affiliations

Inferior glenohumeral joint capsule thickness in frozen shoulder via ultrasonography

Toru Inada et al. JSES Int. .

Abstract

Background: The thickening of the inferior glenohumeral joint capsule (IGC) is a characteristic finding in frozen shoulders. However, the relationship between the thickness of the IGC measured using ultrasonography (US) and the range of motion (ROM) remains unclear. This study aimed to investigate a suitable IGC thickness measurement site that can reflect the ROM of frozen shoulders.

Methods: The participants were 29 patients with frozen shoulder and 20 healthy shoulders of 10 healthy adult. US measurements of the IGC were performed at 80° elevation in the scapular plane, with thickness was measured at 3 levels in both groups: just above the surgical neck, just above the anatomical neck, and at the parenchymal level. The relationship between thickness and ROM at the 3 levels was also assessed. The thickness of the IGC was evaluated using magnetic resonance imaging and US, as well as the validity of US evaluation.

Results: There was a positive correlation (r = 0.72) between magnetic resonance imaging-measured and US-measured IGC thickness. The IGC was thicker in the frozen shoulder group than in the control group at all 3 levels (P < .001). The thickness of the IGC at the parenchymal level showed a significant negative correlation with all ROMs: flexion (r = -0.63), abduction (r = -0.60), external rotation (r = -0.50), and internal rotation (r = -0.52).

Conclusion: The thickness of the IGC at the parenchymal level is negatively correlated with the ROM. The evaluation of the IGC in this study will be helpful in selecting treatment options for frozen shoulders.

Keywords: Adhesive capsulitis; Axillary recess; Frozen shoulder; Inferior glenohumeral joint capsule; Range of motion; Ultrasonography.

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Figures

Figure 1
Figure 1
Measurement position of the inferior glenohumeral joint capsule in ultrasonography.
Figure 2
Figure 2
Methods of imaging the inferior glenohumeral joint capsule in ultrasonography. Short axis view (A) and long axis view (B). HH, humeral head; AN, anatomical neck; SN, surgical neck; cap, capsule; TM, teres major.
Figure 3
Figure 3
Measurement site for inferior glenohumeral joint capsule thickness in ultrasonography. The surgical neck level (yellow arrow), the anatomical neck level (blue arrow), and the parenchymal level (red arrow). HH, humeral head; AN, anatomical neck; SN, surgical neck.
Figure 4
Figure 4
Measurement site for inferior glenohumeral capsule thickness in MRI.
Figure 5
Figure 5
Relationship between MRI and US inferior glenohumeral joint capsule thickness. MRI, magnetic resonance imaging; US, ultrasonography.
Figure 6
Figure 6
Folding back of the inferior glenohumeral joint capsule.
Figure 7
Figure 7
Intra-articular edema. HH, humeral head; AN, anatomical neck; SN, surgical neck; ∗, edema.
See this image and copyright information in PMC

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