Utility of MR arthrography in the diagnosis of adhesive capsulitis

Objective. Arthrographically, adhesive capsulitis is characterized by decre ased joint volume; histologically, the capsule and synovium are thickened. We therefore compared using MR arthrography the joint volumes and capsule/s ynovial thickness of patients with and without adhesive capsulitis in order to assess the utility of MR arthrography in diagnosing adhesive capsulitis . Design and patients. The 1.5 T MR arthrography images of 28 subjects with ( n=9) and without (n=19) adhesive capsulitis were compared. Adhesive capsuli tis was diagnosed when there was an injected glenohumeral joint volume of l ess than 10 mi. Two masked observers working in consensus assessed the imag es for the relative amount of fluid in the biceps tendon sheath and axillar y recess, corrugation at the margin of the capsule, capsule/synovial thickn ess, abnormalities of the rotator interval capsule, and for the presence of a cuff tear. Results. There was a trend towards differences in capsular and synovial thi ckness (P>0.07) between the subjects with and without adhesive capsulitis; however, the controls had thicker synovium/capsules. Surprisingly, the amou nt of fluid in the axillary recess and biceps tendon sheath was not signifi cantly different between the groups (P>0.25). There were more tears of the rotator cuff in controls than in patients with adhesive capsulitis (6, 3 vs 1, 1: complete, partial). Also, both corrugation (7 vs 0) and interval abn ormalities (7 vs 0) were more common in the controls. Conclusion. There appear to be no useful MR arthrographic signs of adhesive capsulitis. Capsular/synovial thickness, static fluid volume, and the pres ence of corrugation are inconclusive as MR arthrographic signs for distingu ishing shoulders with adhesive capsulitis from those without.