MR Imaging Biomarkers for Clinical Impairment and Disease Progression in Patients with Shoulder Adhesive Capsulitis: A Prospective Study

Abstract

Background: MRI diagnostic criteria of shoulder adhesive capsulitis (AC) are nowadays widely used, but there is little information available on the association between MRI findings and clinical impairment. Purpose: To determine the correlation of MRI findings with the Constant–Murley Score (CMS), pain duration and symptoms at the one-year follow-up in AC patients. Materials and methods: This monocentric prospective study included 132 patients with a clinical diagnosis of shoulder AC who underwent shoulder MRI. Mean patient age was 54.1 ± 9.3 years, and there were 55 men and 77 women. A radiologist examined all patients and completed the CMS just prior to MRI. Pain duration was assessed along with the signal intensity and measured the maximal thickness of the inferior glenohumeral ligament (IGHL) by two radiologists. Medical record analysis was performed in a sub-group of 49 patients to assess prognosis approximately one year after the MRI examination. Linear regression analysis with the Pearson test and the Fisher exact test were used to determine the association between MRI findings and clinical impairment. Results: There was a significant difference in mean pain duration score (3.8 ± 1.2 versus 3.2 ± 0.9 and 3.8 ± 1.2 versus 3.2 ± 0.9, respectively, for readers 1 and 2) and in mean mobility scores (15.7 ± 8 points versus 19.6 ± 10.1 points and 15.8 ± 8.2 points versus 19.4 ± 10 points, respectively, for readers 1 and 2) in patients with a high IGHL signal compared to those with a low IGHL signal (p < 0.05). IGHL was thicker in patients with clinical improvement at one-year follow-up compared to those presenting clinical stability or worsening (p < 0.05). Conclusions: In patients with shoulder AC, the degree of signal intensity at the IGHL was inversely related to shoulder pain duration and range of motion, and a thickened IGHL indicated a favorable outcome at one-year follow-up.

What is the most predictive magnetic resonance imaging finding of rotator cuff tear concomitant with shoulder stiffness?

“…Therefore, it is difficult to interpret that the MRI scan exactly represents the patient’s stiffness. However, as stiffness does not usually resolve in a short period, 8 the effect would not be clinically significant.…”

Evaluation of the Differences in the MRI Findings Related to Primary and Secondary Adhesive Capsulitis

“…There is no consensus on the use of the increase in signal intensity of the joint capsule at the axillary recess level in the diagnosis of adhesive capsulitis since the evaluation of this increase often varies from person to person. In a prospective study by Gillet et al, 17 in which the relationship between MRI findings and clinical examination findings was investigated in patients with adhesive capsulitis, joint capsule thicknesses of the patients were measured at the axillary recess level, and the signal intensities of the joint capsule thereof were graded using 4 different grade levels. Consequentially, it was found that the pain and mobility scores, which are the clinical criteria investigated within the scope of the study, were found to have differed between the low and high signal intensity groups ( P < 0.05).…”

Acurácia diagnóstica da ressonância magnética sem contraste no ombro congelado

“…Gillet et al 67 , em 2021, publicam estudo em que são avaliadas RM de achados compatíveis com a doença na RM são correlacionados com dados clínicos e com a evolução em relação à dor. As RM são avaliadas por dois radiologistas com 3 e 7 anos de experiência e os parâmetros documentados incluem: presença de hipersinal do ligamento glenoumeral inferior, espessura da cápsula no recesso axilar (porção umeral e glenoidal) e espessura do ligamento coracoumeral.…”