Tamiladu & Pondicherry Chapter of Indian Radiological and Imaging Association
Promoting the study and practice of Diagnostic Radiological Imaging Modalities in the states of Tamilnadu and Pondicherry
Answer to Quiz No. 69 dated 03 Jul 2016
Adhesive capsulitis
Findings
sagittal and axial fat saturated PD weighted images show abnormal soft tissue lesion with thickening of the coracohumeral ligament in the rotator interval. coronal T2 weighted image show thickening of the inferior glenohumeral ligament in the axillary pouch.
Discussion
Adhesive capsulitis or “frozen shoulder” is an inflammatory condition of the glenohumeral joint synovium and capsule leading to a restricted range of motion. It is most commonly encountered in female patients who are 40 to 60 years of age. Primary or idiopathic adhesive capsulitis is encountered in the absence of preceding trauma. Secondary adhesive capsulitis or post-traumatic arthritis results from antecedent injury, low-level repetitive trauma, surgery, or rheumatologic conditions. The abnormalities most commonly involve the rotator interval capsule, the biceps tendon root, and the inferior and posterior capsule. The clinical diagnosis of idiopathic adhesive capsulitis relies on the detection of a global decreased range of motion at the glenohumeral joint, absence of previous major trauma, and a normal joint space on plain radiographs. The rotator interval lies between the supraspinatus muscle and tendon posterosuperiorly and the subscapularis muscle and tendon anteroinferiorly. The rotator interval capsule is composed of the coracohumeral ligament and the superior glenohumeral ligament. The MRI findings that suggest adhesive capsulitis include soft tissue thickening in the rotator interval, which may encase the coracohumeral and superior glenohumeral ligaments, and soft tissue thickening adjacent to the biceps anchor . A thickened inferior glenohumeral ligament greater than 4 mm is often seen in the axillary pouch . Loss of definition of the inferior capsule secondary to edema and synovitis may also be demonstrated. IV gadolinium enhancement increases the specificity of the diagnosis by demonstrating enhancement of the rotator interval capsule and enhancement of the capsuloligamentous structures in the axillary recess.
References
Michael E. Stadnick. M.D, radsource, Adhesive Capsulitis
Findings
sagittal and axial fat saturated PD weighted images show abnormal soft tissue lesion with thickening of the coracohumeral ligament in the rotator interval. coronal T2 weighted image show thickening of the inferior glenohumeral ligament in the axillary pouch.
Discussion
Adhesive capsulitis or “frozen shoulder” is an inflammatory condition of the glenohumeral joint synovium and capsule leading to a restricted range of motion. It is most commonly encountered in female patients who are 40 to 60 years of age. Primary or idiopathic adhesive capsulitis is encountered in the absence of preceding trauma. Secondary adhesive capsulitis or post-traumatic arthritis results from antecedent injury, low-level repetitive trauma, surgery, or rheumatologic conditions. The abnormalities most commonly involve the rotator interval capsule, the biceps tendon root, and the inferior and posterior capsule. The clinical diagnosis of idiopathic adhesive capsulitis relies on the detection of a global decreased range of motion at the glenohumeral joint, absence of previous major trauma, and a normal joint space on plain radiographs. The rotator interval lies between the supraspinatus muscle and tendon posterosuperiorly and the subscapularis muscle and tendon anteroinferiorly. The rotator interval capsule is composed of the coracohumeral ligament and the superior glenohumeral ligament. The MRI findings that suggest adhesive capsulitis include soft tissue thickening in the rotator interval, which may encase the coracohumeral and superior glenohumeral ligaments, and soft tissue thickening adjacent to the biceps anchor . A thickened inferior glenohumeral ligament greater than 4 mm is often seen in the axillary pouch . Loss of definition of the inferior capsule secondary to edema and synovitis may also be demonstrated. IV gadolinium enhancement increases the specificity of the diagnosis by demonstrating enhancement of the rotator interval capsule and enhancement of the capsuloligamentous structures in the axillary recess.
References
Michael E. Stadnick. M.D, radsource, Adhesive Capsulitis
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