Determination of magnetic resonance imaging criteria for diagnosis of adhesive capsulitis
The objective of this study was to identify optimal magnetic resonance imaging (MRI) parameters and their cutoff values for diagnosing adhesive capsulitis (AC). One hundred shoulder MRI images with stage 2 AC (AC group) and 100 MRI images without AC (control group) were randomly reviewed by two experienced shoulder specialists. They were asked whether MRI findings were compatible with AC and measurement of MRI parameters. Sensitivity, specificity, and accuracy were calculated. Correlation between MRI parameters and the range of motions was also analyzed. The mean capsular thickness in the axillary recess (AR) (5.9 mm in the AC group vs. 3.6 mm in the control group) on coronal oblique T2-weighted images and the rotator interval (RI) (7.2 mm vs. 4.8 mm, respectively) on oblique sagittal proton-density images were significantly greater in the AC group than in the control group, whereas the width of RI showed no significant difference between two groups. The highest diagnostic cutoff values were 4.5 mm for the AR and 6 mm for the RI, with sensitivity (91% and 88%, respectively), specificity (90% and 90%), and accuracy (90% and 89%). Capsular thickness in the AR and RI was significantly correlated with external rotation (P = 0.047) and internal rotation (P = 0.023). On conventional MRI, capsular thickness greater than 4.5 mm in the AR or 6 mm in the RI can be an optimal criterion for diagnosing AC. Capsular thickness in the AR and RI was correlated with the range of rotational motion.
KeywordsAdhesive capsulitis Axillary recess Rotator interval Magnetic resonance image
Jae Hoon Jung and Du Hwan Kim are co-first authors. We thank Eun-Ji Jeon and Yeji Kim for their support with data collection. We thank Scott Timpano for editing a draft of this manuscript.
JHJ, DHK, and C-HC were responsible for the conceptualization and design of the study, and wrote the manuscript. D-HK collected the data and statistical analysis. JHY contributed interpretation of data and critical review.
This work was supported by the Bisa Research Grant of Keimyung University in 2016.
Compliance with ethical standards
Conflict of interest
Jae Hoon Jung declares that he has no conflict of interest. Du Hwan Kim declares that he has no conflict of interest. Jaehyuck Yi declares that he has no conflict of interest. Du-Han Kim declares that he has no conflict of interest. Chul-Hyun Cho declares that he has no conflict of interest.
This study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The authors obtained the approval of Keimyung University Dongsan Medical Center institutional review board (IRB number 2016-07-032) with exemption of Informed consent for this study.
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