The glenohumeral joint capsule is attached medially to the neck of the glenoid bone, laterally to the humeral neck, and superiorly to the coracoid process (Figure 1). The three anatomicalallocations affected by adhesive capsulitis in the shoulder joint are the synovium of the long head of the biceps tendon, rotator interval structures, and axillary recess capsule. The long head of the biceps tendon is covered by tendon synovium in the bicipital groove. The rotator interval is a three-angular anatomical structure localized between the anterosuperior border of the supraspinatus tendon and the superior border of the subscapularis tendon. Anterior and posterior bands of the inferior glenohumeral ligament reinforce the axillary recess capsule.Adhesive capsulitis is commonly diagnosed on the basis of characteristic clinical features. However, in some cases, it may clinically mimic other causes of shoulder pain and restricted joint movement such as rotator cuff tear, subacromial impingement, calcific tendinitis, labral injury, and/ or degenerative arthropathy. 1 Imaging methods including ultrasonography, MR imaging, CT, MR arthrography, CT arthrography, and conventional arthrography are frequently used to exclude these causes. Imaging modalities may also be particularly useful when surgical treatment is planned.

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Objective: To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results. Methods: 82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography. Results: In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold (p > 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, p < 0.05). Conclusion: Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography. Advances in knowledge: Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon. Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint. Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).

This study evaluated cases of spontaneous pneumothorax developing secondary to SARS-CoV-2 pneumonia. Sixteen cases presenting to our hospital due to spontaneous pneumothorax developing secondary to SARS-CoV-2 pneumonia between March 2020 and February 2020 were evaluated retrospectively. Ten patients (62.5%) were men, and six (37.5%) were women, with a mean age of 68 ± 20.3 years (range 18 - 90 years). Pneumothorax was in the right hemithorax in 11 cases (68.75%), in the left hemithorax in two (12.5%), and bilateral in three (17.75%). Pneumothorax developed during active SARS-CoV-2 pneumonia in all 16 cases (100%). No pneumothorax was detected following the healing of SARS-CoV-2 infection. Pneumothorax was observed while patients were not intubated in 15 cases (93.75%), but pneumothorax developed during mechanical ventilation in one case (6.25%). Tube thoracostomy was performed on all patients in treatment. Air leakage from the tube was observed in 14 cases (87.5%). The mean duration of tube thoracostomy was 18.3 ± 20.1 days (range 1 - 81 days). Pneumothorax resolved after treatment in seven cases (43.75%), while mortality occurred in nine (56.25%). Pneumothorax recurred after treatment in one case (6.25%). Pneumothorax is widely seen in the active period or after healing in cases infected with COVID-19. Aggressive treatment is generally required for this clinical manifestation with high mortality.

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