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Adhesive Capsulitis of the Shoulder: Diagnosis Using Magnetic Resonance Arthrography, with Arthroscopic Findings as the Standard

Lee, Min Hee MD; Ahn, Joong Mo MD; Muhle, Claus MD; Kim, Sung Hyun MD; Park, Ji Seon MD; Kim, Seung Ho MD; Kim, Sung Moon MD; Kang, Heung Sik MD

Journal of Computer Assisted Tomography: November-December 2003 - Volume 27 - Issue 6 - p 901-906
Musculoskeletal Radiology: ORIGINAL ARTICLE

Objective The purpose of this study was to assess the usefulness of magnetic resonance (MR) arthrography of the glenohumeral joint in the diagnosis of adhesive capsulitis.

Methods MR arthrography of the glenohumeral joint was performed in 16 patients with arthroscopically proven adhesive capsulitis and 11 controls. Thickness of the joint capsule and synovium, filling ratio of the fluid-distended axillary recess to the posterior joint cavity, and a width of the rotator cuff interval were measured by 2 musculoskeletal radiologists. The measurements of those parameters for the patients with adhesive capsulitis and the controls were compared. Interobserver variability for the measurements of each parameter was calculated.

Results The mean thickness of the joint capsule and synovium was 2.97 mm in patients with adhesive capsulitis and 1.86 mm in controls (P < 0.001). The mean filling ratio of the fluid-distended axillary to the posterior joint cavity was 0.51 in patients with adhesive capsulitis and 0.82 in controls (P = 0.004). The mean width of the rotator cuff interval was 7.45 mm in patients with adhesive capsulitis and 8.48 mm in controls (P > 0.05). Intraclass correlation coefficient for interobserver variability showed good agreement (95% CI; 0.72–0.95).

Conclusions On MR arthrography, thickening of the joint capsule and synovium and diminished filling ratio of the axillary recess to posterior joint cavity appeared to be useful diagnostic criteria for the diagnosis of adhesive capsulitis of the shoulder.

From the Departments of Radiology (Drs Lee, Ahn, Sung Hyun Kim, and Park) and Orthopedic Surgery (Dr Seung Ho Kim), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Nuclear Medicine, Christian-Albrechts University of Kiel, Kiel, Germany (Dr Muhle); Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (Dr Sung Moon Kim); and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (Dr Kang).

Reprints: Joong Mo Ahn, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Kangnamgu, Seoul 135-710, Korea (e-mail: jmahn@smc.samsung.co.kr).

© 2003 Lippincott Williams & Wilkins, Inc.