Skip to main content
SpringerLink
Log in

Systematic review and meta-analysis of magnetic resonance imaging features for diagnosis of adhesive capsulitis of the shoulder

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To perform a systematic review and meta-analysis to identify magnetic resonance imaging (MRI) features that will aid in the diagnosis of adhesive capsulitis of the shoulder (ACS) and provide a summary of the diagnostic accuracy of the identified features

Methods

The MEDLINE and EMBASE databases were searched for studies assessing the diagnostic accuracy of MRI features of ACS. Overlapping descriptors used to denote the same imaging finding in different studies were subsumed under a single feature. The pooled accuracy including the diagnostic odd ratios (DORs) with 95% confidence intervals (CIs) of the identified features was calculated using a bivariate random-effects model.

Results

In total, 15 studies were included, and 74 overlapping descriptors were subsumed under six features. All six features were found to be informative for ACS diagnosis [coracohumeral ligament thickening: DOR, 13; 95% CI, 6-29; fat obliteration of the rotator interval (RI): DOR, 8; 95% CI, 3-24; RI enhancement: DOR, 44; 95% CI, 14-141; axillary joint capsule enhancement: DOR, 52; 95% CI, 27-98; inferior glenohumeral ligament (IGHL) hyperintensity: DOR, 31; 95% CI, 8-115; IGHL thickening: DOR, 28; 95% CI, 11-70]. The sensitivity and specificity of enhancement of the RI and axillary joint capsule and IGHL hyperintensity were > 80%.

Conclusions

Six informative MRI features for ACS diagnosis were identified in this study with RI and axillary joint capsule enhancement and IGHL hyperintensity showing the highest diagnostic accuracy. Informative features observed on non-arthrogram MRI can be as helpful as features observed on direct magnetic resonance arthrography for ACS diagnosis.

Key points

• Six informative MRI features for ACS diagnosis were identified (diagnostic odds ratio > 1).

• RI and axillary joint capsule enhancement and IGHL hyperintensity showed high sensitivities/specificities (> 80%).

• The use of non-arthrogram MRI is recommended for ACS diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

ACS:

Adhesive capsulitis of the shoulder

CE:

Contrast enhanced

CHL:

Coracohumeral ligament

CI:

Confidence interval

DOR:

Diagnostic odds ratios

IGHL:

Inferior glenohumeral ligament

RI:

Rotator interval

References

  1. Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA (2011) Current review of adhesive capsulitis. J Shoulder Elbow Surg 20:502–514

    Article  Google Scholar 

  2. Harris G, Bou-Haidar P, Harris C (2013) Adhesive capsulitis: review of imaging and treatment. J Med Imaging Radiat Oncol 57:633–643

    Article  Google Scholar 

  3. Brue S, Valentin A, Forssblad M, Werner S, Mikkelsen C, Cerulli G (2007) Idiopathic adhesive capsulitis of the shoulder: a review. Knee Surg Sports Traumatol Arthrosc 15:1048–1054

    Article  CAS  Google Scholar 

  4. Boenisch U, Lembcke O, Naumann T (2000) Classification, clinical findings and operative treatment of degenerative and posttraumatic shoulder disease: what do we really need to know from an imaging report to establish a treatment strategy? Eur J Radiol 35:103–118

    Article  CAS  Google Scholar 

  5. Zappia M, Di Pietto F, Aliprandi A et al (2016) Multi-modal imaging of adhesive capsulitis of the shoulder. Insights Imaging 7:365–371

    Article  Google Scholar 

  6. McInnes MDF, Moher D, Thombs BD et al (2018) Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: The PRISMA-DTA Statement. JAMA 319:388–396

    Article  Google Scholar 

  7. Whiting PF, Rutjes AW, Westwood ME et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536

    Article  Google Scholar 

  8. Lee J, Kim KW, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part II. Statistical methods of meta-analysis. Korean J Radiol 16:1188–1196

    Article  Google Scholar 

  9. Higgins J, Green S Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration. http://handbook.cochrane.org/chapter_9/9_5_2_identifying_and_measuring_heterogeneity.htm.

  10. Deville WL, Buntinx F, Bouter LM et al (2002) Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol 2:9

    Article  Google Scholar 

  11. Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893

    Article  Google Scholar 

  12. Ahn KS, Kang CH, Kim Y, Jeong WK (2015) Diagnosis of adhesive capsulitis: comparison of contrast-enhanced MRI with noncontrast-enhanced MRI. Clin Imaging 39:1061–1067

    Article  Google Scholar 

  13. Carbone S, Napoli A, Gumina S (2014) MRI of adhesive capsulitis of the shoulder: distension of the bursa in the superior subscapularis recess is a suggestive sign of the pathology. Eur J Radiol 83:345–348

    Article  Google Scholar 

  14. Carrillon Y, Noel E, Fantino O, Perrin-Fayolle O, Tran-Minh VA (1999) Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. Rev Rhum Engl Ed 66:201–206

    CAS  Google Scholar 

  15. Chi AS, Kim J, Long SS, Morrison WB, Zoga AC (2017) Non-contrast MRI diagnosis of adhesive capsulitis of the shoulder. Clin Imaging 44:46–50

    Article  Google Scholar 

  16. Connell D, Padmanabhan R, Buchbinder R (2002) Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol 12:2100–2106

    Article  Google Scholar 

  17. Emig EW, Schweitzer ME, Karasick D, Lubowitz J (1995) Adhesive capsulitis of the shoulder: MR diagnosis. AJR Am J Roentgenol 164:1457–1459

    Article  CAS  Google Scholar 

  18. Gokalp G, Algin O, Yildirim N, Yazici Z (2011) Adhesive capsulitis: contrast-enhanced shoulder MRI findings. J Med Imaging Radiat Oncol 55:119–125

    Article  Google Scholar 

  19. Gondim Teixeira PA, Balaj C, Chanson A, Lecocq S, Louis M, Blum A (2012) Adhesive capsulitis of the shoulder: value of inferior glenohumeral ligament signal changes on T2-weighted fat-saturated images. AJR Am J Roentgenol 198:W589–W596

    Article  Google Scholar 

  20. Jung JY, Jee WH, Chun HJ, Kim YS, Chung YG, Kim JM (2006) Adhesive capsulitis of the shoulder: evaluation with MR arthrography. Eur Radiol 16:791–796

    Article  Google Scholar 

  21. Lee SY, Park J, Song SW (2012) Correlation of MR arthrographic findings and range of shoulder motions in patients with frozen shoulder. AJR Am J Roentgenol 198:173–179

    Article  Google Scholar 

  22. Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M (2004) Frozen shoulder: MR arthrographic findings. Radiology 233:486–492

    Article  Google Scholar 

  23. Sasanuma H, Sugimoto H, Fujita A et al (2017) Characteristics of dynamic magnetic resonance imaging of idiopathic severe frozen shoulder. J Shoulder Elbow Surg 26:e52–e57

    Article  Google Scholar 

  24. Song KD, Kwon JW, Yoon YC, Choi SH (2011) Indirect MR arthrographic findings of adhesive capsulitis. AJR Am J Roentgenol 197:W1105–W1109

    Article  Google Scholar 

  25. Yoon JP, Chung SW, Lee BJ et al (2017) Correlations of magnetic resonance imaging findings with clinical symptom severity and prognosis of frozen shoulder. Knee Surg Sports Traumatol Arthrosc 25:3242–3250

    Article  Google Scholar 

  26. Zhao W, Zheng X, Liu Y et al (2012) An MRI study of symptomatic adhesive capsulitis. PLoS One 7:e47277

    Article  CAS  Google Scholar 

  27. Ahn KS, Kang CH, Oh YW, Jeong WK (2012) Correlation between magnetic resonance imaging and clinical impairment in patients with adhesive capsulitis. Skeletal Radiol 41:1301–1308

    Article  Google Scholar 

  28. Park GY, Park JH, Kwon DR, Kwon DG, Park J (2017) Do the findings of magnetic resonance imaging, arthrography, and ultrasonography reflect clinical impairment in patients with idiopathic adhesive capsulitis of the shoulder? Arch Phys Med Rehabil 98:1995–2001

    Article  Google Scholar 

  29. Park S, Lee DH, Yoon SH, Lee HY, Kwack KS (2016) Evaluation of adhesive capsulitis of the shoulder with fat-suppressed T2-weighted MRI: association between clinical features and mri findings. AJR Am J Roentgenol 207:135–141

    Article  Google Scholar 

  30. Park YH, Park YS, Chang HJ, Kim Y (2016) Correlations between MRI findings and outcome of capsular distension in adhesive capsulitis of the shoulder. J Phys Ther Sci 28:2798–2802

    Article  Google Scholar 

  31. Sofka CM, Ciavarra GA, Hannafin JA, Cordasco FA, Potter HG (2008) Magnetic resonance imaging of adhesive capsulitis: correlation with clinical staging. HSS J 4:164–169

    Article  Google Scholar 

  32. Hannafin JA, Chiaia TA (2000) Adhesive capsulitis. A treatment approach. Clin Orthop Relat Res:95–109

  33. Bulgen DY, Binder A, Hazleman BL, Park JR (1982) Immunological studies in frozen shoulder. J Rheumatol 9:893–898

    CAS  Google Scholar 

  34. Bunker TD, Reilly J, Baird KS, Hamblen DL (2000) Expression of growth factors, cytokines and matrix metalloproteinases in frozen shoulder. J Bone Joint Surg Br 82:768–773

    Article  CAS  Google Scholar 

  35. Lee JC, Sykes C, Saifuddin A, Connell D (2005) Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol 34:522–527

    Article  CAS  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Chong Hyun Suh

  2. Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea

    Seong Jong Yun, Wook Jin & So Young Park

  3. Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea

    Sun Hwa Lee

  4. Department of Radiology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea

    Ji Seon Park & Kyung Nam Ryu

Authors
  1. Chong Hyun Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seong Jong Yun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wook Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sun Hwa Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. So Young Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ji Seon Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kyung Nam Ryu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seong Jong Yun.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Seong Jong Yun, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Chong Hyun Suh, MD) has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because the nature of our study was a systemic review and meta-analysis.

Ethical approval

Institutional Review Board approval was not required because the nature of our study was a systematic review and meta-analysis.

Methodology

• meta-analysis

• performed at one institution

Electronic supplementary material

ESM 1

(DOC 11294 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suh, C.H., Yun, S.J., Jin, W. et al. Systematic review and meta-analysis of magnetic resonance imaging features for diagnosis of adhesive capsulitis of the shoulder. Eur Radiol 29, 566–577 (2019). https://doi.org/10.1007/s00330-018-5604-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-018-5604-y

Keywords

Search

Navigation