Magnetic resonance imaging of adhesive capsulitis: correlation with clinical staging

Abstract

The purpose of this study was to evaluate non-contrast magnetic resonance imaging (MRI) findings of adhesive capsulitis and correlate them with clinical stages of adhesive capsulitis. This will hopefully define a role for shoulder MR imaging in the diagnosis of adhesive capsulitis as well as in potentially directing appropriate treatment. Forty-seven consecutive non-contrast magnetic resonance imaging examinations of 46 patients with a clinical diagnosis of adhesive capsulitis were retrospectively reviewed and correlated with clinical staging. Specific MRI criteria correlated with the clinical stage of adhesive capsulitis, including the thickness and signal intensity of the joint capsule and synovium as well as the presence and severity of scarring in the rotator interval. Routine MRI of the shoulder without intraarticular administration of gadolinium can be used to diagnose all stages of adhesive capsulitis, including stage 1, where findings may be subtle on clinical examination. We believe that future studies assessing the role of MRI in guiding the initiation of appropriate treatment should be undertaken.

Figures

Fig. 1

a Oblique coronal proton density FSE image of a 55-year-old man with clinical stage 1 adhesive capsulitis. There is thickening of the axillary pouch, which is only mildly hyperintense (arrow). b Axial proton density FSE image of the same patient demonstrates moderate scarring of the rotator interval (arrow)

Fig. 2

a Oblique coronal proton density FSE image of a 57-year-old woman with clinical stage 2 adhesive capsulitis. Note the moderately thickened, hyperintense capsule at the level of the axillary pouch (arrow). b Axial proton density FSE image of the same patient demonstrates mild hyperintensity in the rotator interval (arrow)

Fig. 3

a Oblique coronal proton density FSE image of a 48-year-old woman with clinical stage 3 adhesive capsulitis. There is mild thickening of the capsule, which is hypointense (arrow). b Axial proton density FSE image of the same patient demonstrates mild scarring in the rotator interval (arrow)

Fig. 4

a Oblique coronal proton density FSE image of a 62-year-old man with clinical stage 4 adhesive capsulitis. The capsule is mildly thickened, redundant, and hypointense (arrow). b Axial proton density FSE image of the same patient shows mild scarring in the rotator interval (arrow)