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Ultrasound measurements of axillary recess capsule thickness in unilateral frozen shoulder: study of correlation with MRI measurements

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Abstract

Objective

The aims of this study were to compare the ultrasound thickness of the affected axillary recess capsule (ARC) with that of the unaffected ARC in patients with frozen shoulder (FS), to analyze whether the ultrasound measurements of the ARC thickness correlate with those obtained using MRI, and to assess whether the ultrasound thickness of the ARC correlates with the patterns of range of motion limitation.

Materials and methods

Forty-four patients with clinically diagnosed unilateral FS and MRI evaluation performed ultrasound measurement of ARC. The ultrasound measurement of the ARC thickness was performed with the patients in a supine position with their shoulder abducted by 40°. The ARC thickness was also measured by MRI on oblique coronal images by another physician blinded to the ultrasound measurements. With both ultrasound and MRI, ARC thickness was determined at the widest portion of the capsule.

Results

The ultrasound thickness of ARC was significantly higher in the affected shoulder (4.4 ± 1.1 mm) than in the unaffected one (2.2 ± 0.5 mm) (p < 0.001). The ultrasound thickness of the ARC in the affected shoulder correlated with that measured by MRI (8.9 ± 1.9 mm) (p < 0.001, r = 0.83). The ARC thickness, whether measured by ultrasound or MRI, was not significantly related to the limitation of movement in specific directions.

Conclusion

Ultrasound can demonstrate the difference in ARC thickness between affected and unaffected shoulders in patients with unilateral FS. The ARC thickness measured by ultrasound correlates with that measured by MRI.

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References

  1. Hannafin JA, Chiaia TA. Adhesive capsulitis. A treatment approach. Clin Orthop Relat Res. 2000;95–109.

    Article  Google Scholar 

  2. Hand GC, Athanasou NA, Matthews T, Carr AJ. The pathology of frozen shoulder. J Bone Joint Surg Br. 2007;89:928–32.

    Article  CAS  PubMed  Google Scholar 

  3. Zappia M, Di Pietto F, Aliprandi A, et al. Multi-modal imaging of adhesive capsulitis of the shoulder. Insights Imaging. 2016;7:365–71.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ahn KS, Kang CH, Oh YW, Jeong WK. Correlation between magnetic resonance imaging and clinical impairment in patients with adhesive capsulitis. Skeletal Radiol. 2012;41:1301–8.

    Article  PubMed  Google Scholar 

  5. Carrillon Y, Noel E, Fantino O, Perrin-Fayolle O, Tran-Minh VA. Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. Rev Rhum Engl Ed. 1999;66:201–6.

    CAS  PubMed  Google Scholar 

  6. Connell D, Padmanabhan R, Buchbinder R. Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol. 2002;12:2100–6.

    Article  PubMed  Google Scholar 

  7. Emig EW, Schweitzer ME, Karasick D, Lubowitz J. Adhesive capsulitis of the shoulder: MR diagnosis. AJR Am J Roentgenol. 1995;164:1457–9.

    Article  CAS  PubMed  Google Scholar 

  8. Jung JY, Jee WH, Chun HJ, Kim YS, Chung YG, Kim JM. Adhesive capsulitis of the shoulder: evaluation with MR arthrography. Eur Radiol. 2006;16:791–6.

    Article  PubMed  Google Scholar 

  9. Lee MH, Ahn JM, Muhle C, et al. Adhesive capsulitis of the shoulder: diagnosis using magnetic resonance arthrography, with arthroscopic findings as the standard. J Comput Assist Tomogr. 2003;27:901–6.

    Article  PubMed  Google Scholar 

  10. Lefevre-Colau MM, Drape JL, Fayad F, et al. Magnetic resonance imaging of shoulders with idiopathic adhesive capsulitis: reliability of measures. Eur Radiol. 2005;15:2415–22.

    Article  PubMed  Google Scholar 

  11. Manton GL, Schweitzer ME, Weishaupt D, Karasick D. Utility of MR arthrography in the diagnosis of adhesive capsulitis. Skeletal Radiol. 2001;30:326–30.

    Article  CAS  PubMed  Google Scholar 

  12. Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M. Frozen shoulder: MR arthrographic findings. Radiology. 2004;233:486–92.

    Article  PubMed  Google Scholar 

  13. Park S, Lee DH, Yoon SH, Lee HY, Kwack KS. Evaluation of adhesive capsulitis of the shoulder with fat-suppressed T2-weighted MRI: association between clinical features and MRI findings. AJR Am J Roentgenol. 2016;207:135–41.

    Article  PubMed  Google Scholar 

  14. Sofka CM, Ciavarra GA, Hannafin JA, Cordasco FA, Potter HG. Magnetic resonance imaging of adhesive capsulitis: correlation with clinical staging. HSS J. 2008;4:164–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tamai K, Akutsu M, Yano Y. Primary frozen shoulder: brief review of pathology and imaging abnormalities. J Orthop Sci. 2014;19:1–5.

    Article  PubMed  Google Scholar 

  16. Homsi C, Bordalo-Rodrigues M, da Silva JJ, Stump XM. Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool? Skeletal Radiol. 2006;35:673–8.

    Article  PubMed  Google Scholar 

  17. Lee JC, Sykes C, Saifuddin A, Connell D. Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol. 2005;34:522–7.

    Article  CAS  PubMed  Google Scholar 

  18. Walmsley S, Osmotherly PG, Walker CJ, Rivett DA. Power Doppler ultrasonography in the early diagnosis of primary/idiopathic adhesive capsulitis: an exploratory study. J Manip Physiol Ther. 2013;36:428–35.

    Article  Google Scholar 

  19. Wu CH, Chen WS, Wang TG. Elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder. Radiology. 2016;278:458–64.

    Article  PubMed  Google Scholar 

  20. Michelin P, Delarue Y, Duparc F, Dacher JN. Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture. Eur Radiol. 2013;23:2802–6.

    Article  PubMed  Google Scholar 

  21. Cyriax J, editor. Textbook of orthopedic medicine. 7th ed. New York: Macmillan; 1978.

    Google Scholar 

  22. Rundquist PJ, Anderson DD, Guanche CA, Ludewig PM. Shoulder kinematics in subjects with frozen shoulder. Arch Phys Med Rehabil. 2003;84:1473–9.

    Article  PubMed  Google Scholar 

  23. Rundquist PJ, Ludewig PM. Patterns of motion loss in subjects with idiopathic loss of shoulder range of motion. Clin Biomech (Bristol, Avon). 2004;19:810–8.

    Article  Google Scholar 

  24. Kim KT, Lee DG, Lee S, Kim du H. Ultrasonographic measurement of the thickness of axillary recess capsule in healthy volunteers. Ann Rehabil Med. 2016;40:502–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ticker JB, Flatow EL, Pawluk RJ, et al. The inferior glenohumeral ligament: a correlative investigation. J Shoulder Elbow Surg. 2006;15:665–74.

    Article  PubMed  Google Scholar 

  26. Ferrari DA. Capsular ligaments of the shoulder. Anatomical and functional study of the anterior superior capsule. Am J Sports Med. 1990;18:20–4.

    Article  CAS  PubMed  Google Scholar 

  27. Terry GC, Hammon D, France P, Norwood LA. The stabilizing function of passive shoulder restraints. Am J Sports Med. 1991;19:26–34.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Du Hwan Kim.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional review board.

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The authors declare that they have no conflicts of interest. They did not receive any financial support or other benefits from commercial sources for the work reported on this manuscript, nor did any of the authors have any financial interests with regard to the work that may create a potential conflict of interest or the appearance of one. This work has not been presented, submitted, or published in any form or any language.

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Kim, D.H., Cho, CH. & Sung, D.H. Ultrasound measurements of axillary recess capsule thickness in unilateral frozen shoulder: study of correlation with MRI measurements. Skeletal Radiol 47, 1491–1497 (2018). https://doi.org/10.1007/s00256-018-2959-8

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  • DOI: https://doi.org/10.1007/s00256-018-2959-8

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