Ultrasonographic Measurement of the Thickness of Axillary Recess Capsule in Healthy Volunteers

Kim, Kyoung‐Tae; Lee, Dong Gyu; Lee, Soyoung; Kim, Du Hwan

doi:10.5535/arm.2016.40.3.502

Cited by 11 publications

(15 citation statements)

References 27 publications

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“…Further studies are needed to elucidate whether the increased IJC thickness on US is pathognomonic for FS. Third, we did not assess the reliability of US measurement of IJC thickness in patients with FS, although a previous study revealed good reliability in a healthy population [ 29 ]. Lastly, we tried to maintain a standardized position of shoulder abduction; however, there might have been some movements because the patient’s shoulder was not completely fixed.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Ultrasonographic Measurement of Inferior Joint Capsule Thickness in Patients with Unilateral Frozen Shoulder

et al. 2021

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The diagnostic value of ultrasonography (US) for frozen shoulder (FS) is not well established. This study aimed to assess the diagnostic value of US measurement of inferior joint capsule (IJC) thickness and evaluate changes in the thickness of the IJC by US depending on arm position. A total of 71 patients with clinically diagnosed unilateral FS who underwent bilateral US measurement of the IJC were enrolled in this study. The US measurement of the IJC was performed with a linear transducer positioned around the anterior axillary line with the shoulder 40° abducted and with neutral rotation of the glenohumeral joint (neutral position). We also measured the IJC thickness in the externally rotated and internally rotated positions with the shoulder 40° abducted. In the neutral position, as well as in the internally rotated and externally rotated positions, the thickness of the IJC on US was significantly higher in the affected shoulder than that in the unaffected shoulder (all p < 0.001). On both the affected and unaffected sides, the US thickness of the IJC in the neutral position was significantly higher than that in the externally rotated position (p < 0.001), but lower than that in the internally rotated position (p < 0.001). Regarding IJC thickness in the neutral position, a 3.2-mm cutoff value yielded the highest diagnostic accuracy for FS, with a sensitivity and specificity of 73.2% and 77.5%, respectively. The area under the curve for IJC thickness was 0.824 (95% confidence interval, 0.76–0.89). US measurement of the IJC in the neutral position yielded good diagnostic accuracy for FS. Because IJC thickness is affected by arm rotation, it is important to measure the IJC thickness in a standardized posture to ensure diagnostic value.

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Section: Discussionmentioning

confidence: 99%

Dynamic Ultrasonographic Measurement of Inferior Joint Capsule Thickness in Patients with Unilateral Frozen Shoulder

et al. 2021

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“…The ultrasound probe was placed longitudinally on the midaxillary line along the long axis of the humeral shaft. 15,28 AR thickness was determined as the distance from the bony cortex to the outer margin of the glenohumeral joint capsule at the humeral surgical neck. The thickest portion of the AR was measured (Figure 1C).…”

Section: Methodsmentioning

confidence: 99%

Correlation of Ultrasound Findings With Clinical Stages and Impairment in Adhesive Capsulitis of the Shoulder

Geol

Hwang

Yoon

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Ultrasound is an essential tool for diagnosing shoulder disorders. However, the role of ultrasound in assessing and diagnosing adhesive capsulitis has not been fully studied. Purpose: To evaluate the ultrasound features of adhesive capsulitis and estimate the correlations between clinical impairment and ultrasound parameters. Study Design: Case series; Level of evidence, 4. Methods: A total of 61 patients with clinically diagnosed unilateral adhesive capsulitis were retrospectively reviewed using high-resolution ultrasound. To compare ultrasound parameters, we performed ultrasound examinations on both affected and unaffected shoulders. Ultrasound parameters, including thickness of the coracohumeral ligament (CHL), rotator interval (RI), axillary recess (AR), hypervascularity of the RI, and effusion of the long head of the biceps tendon sheath, were measured. Passive range of motion (PROM), visual analog scale for pain, and the Shoulder Pain and Disability Index were used for clinical assessment. Results: The CHL, the RI, and the AR in affected shoulders were significantly thicker than in unaffected shoulders ( P < .05). CHL thickness in affected shoulders was significantly correlated with PROM limitation, which included forward elevation, abduction, external rotation (ER), and internal rotation (IR) ( P < .05). AR thickness correlated with passive forward elevation limitation and passive IR limitation ( P < .05). The CHL was significantly thicker in stage 2 compared with stage 1, and the RI was thicker in stage 2 compared with stage 3. The diagnostic cutoff values for adhesive capsulitis were 2.2 mm for CHL thickness (77% sensitivity, 91.8% specificity) and 4 mm for AR thickness (68.9% sensitivity, 90.2% specificity). Conclusion: The ultrasound parameters associated with structural changes were correlated with clinical characteristics of adhesive capsulitis. Thickened CHL, RI, and AR were observed in affected shoulders. The cutoff values of 2.2 mm for CHL thickness and 4 mm for AR thickness can be used as cutoff diagnostic values for adhesive capsulitis.

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“…With the arm held in a neutral position, the posterior aspect of the GH joint, allowing visualization of the posterior labrum and the infraspinatus tendon, was scanned for evidence of GH effusion. In addition, axillary pouch thickness was measured to determine the presence of GH synovitis, with the patient supine, as recommended by previous researchers [ 18 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…GH synovitis was considered if the distance from the posterior labrum to the infraspinatus tendon exceeded 2 mm (posterior GH synovitis) or if the axillary pouch thickness was >3.5 mm (inferior GH synovitis) [ 24 , 29 ]. The axillary pouch thickness was measured as the distance from the bony cortex of the humerus to the outer margin of the capsule [ 18 , 28 ]. These four grayscale US inflammatory parameters were graded according to a dichotomous evaluation (absence or presence) ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

Comparison of Shoulder Ultrasonographic Assessments between Polymyalgia Rheumatica and Frozen Shoulder in Patients with Bilateral Shoulder Pain: A Comparative Retrospective Study

Park

Cho

et al. 2021

JPM

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This study aimed to assess and compare the ultrasonographic (US) pathologic findings in patients with polymyalgia rheumatica (PMR) and bilateral frozen shoulder (FS). We included 19 patients with clinically diagnosed PMR and 19 patients with stage II bilateral FS. The US evaluation included the assessment of subacromial-subdeltoid (SASD) bursitis, long head of biceps (LHB) tenosynovitis, and posterior and inferior glenohumeral (GH) synovitis. Unilateral SASD bursitis was noted significantly more frequently in PMR patients than in bilateral FS patients (p = 0.001). There were no significant differences in the incidence of unilateral LHB tenosynovitis and posterior GH synovitis between PMR and bilateral FS patients (p = 0.108 and p = 0.304, respectively). Unilateral inferior GH synovitis was more common among bilateral FS patients than among PMR patients (p < 0.001). Bilateral SASD bursitis and LHB tenosynovitis were noted significantly more frequently in PMR patients than in bilateral FS patients (p < 0.001 and 0.049, respectively). Significant differences were not observed in the incidence of bilateral posterior GH synovitis between PMR and bilateral FS patients (p = 0.426). Bilateral inferior GH synovitis was more common among bilateral FS patients than among PMR patients (p = 0.044). The US evidence for bilateral inferior GH synovitis without bilateral SASD showed high specificity (94.7%) with sensitivity (78.9%) for the diagnosis of bilateral FS. SASD bursitis, representing periarticular synovial inflammation, was more common among the patients with PMR than among the patients with bilateral FS. Inferior GH synovitis without SASD bursitis suggests FS rather than PMR in patients with bilateral shoulder pain.

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Ultrasonographic Measurement of the Thickness of Axillary Recess Capsule in Healthy Volunteers

Cited by 11 publications

References 27 publications

Dynamic Ultrasonographic Measurement of Inferior Joint Capsule Thickness in Patients with Unilateral Frozen Shoulder

Dynamic Ultrasonographic Measurement of Inferior Joint Capsule Thickness in Patients with Unilateral Frozen Shoulder

Correlation of Ultrasound Findings With Clinical Stages and Impairment in Adhesive Capsulitis of the Shoulder

Comparison of Shoulder Ultrasonographic Assessments between Polymyalgia Rheumatica and Frozen Shoulder in Patients with Bilateral Shoulder Pain: A Comparative Retrospective Study

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