Radiol 2002 Aug;12(8):2100-6
Adhesive capsulitis: role of MR imaging in differential diagnosis.
Connell D, Padmanabhan R, Buchbinder R.
of MRI, St. Frances Xavier Cabrini Hospital, 183 Wattletree Road, Malvern,
Victoria 3144, Australia, firstname.lastname@example.org
The purpose of this
study was to describe and characterize the MR imaging findings in a group of
patients who underwent surgery for adhesive capsulitis. Twenty-four MR imaging
studies in 24 consecutive patients with clinical evidence of adhesive
capsulitis were performed prior to arthroscopic capsulotomy. There were 17
women and 7 men with a mean age of 53.5 years. Images were scrutinised for
changes in the synovium particularly in the rotator interval, around the
biceps anchor and axillary pouch. Intravenous gadolinium was given routinely.
We also examined a control group of 22 patients who underwent the same MR
imaging protocol after referral for rotator cuff pathology. Soft tissue
density showing variable enhancement after gadolinium administration was
visible in the rotator interval in 22 of 24 studies on MR imaging. Seventeen
patients showed soft tissue density partially encasing the biceps anchor. Ten
patients showed thickening and gadolinium enhancement of the axillary pouch.
Three patients from the study cohort had partial tears of the supraspinatus
tendon. All the patients subsequently had surgery which confirmed
fibrovascular scar tissue in the rotator interval, around the biceps anchor
and a variable degree of synovial inflammation of the glenohumeral capsule.
Two patients from a control group with suspected rotator cuff pathology showed
abnormal intensity in the rotator interval on MR imaging. Magnetic resonance
imaging can identify changes in the shoulder joint that correspond to
abnormalities seen at surgery. This may be useful for discriminating adhesive
capsulitis from other causes of shoulder pain.