European Radiology

, Volume 16, Issue 4, pp 791–796 | Cite as

Adhesive capsulitis of the shoulder: evaluation with MR arthrography

  • Joon-Yong Jung
  • Won-Hee Jee
  • Ho Jong Chun
  • Yang-Soo Kim
  • Yang Guk Chung
  • Jung-Man Kim


The purpose of this study was to determine the usefulness of magnetic resonance (MR) arthrography for diagnosing adhesive capsulitis. Shoulder MR images of 28 patients with (n=14) and without (n=14) adhesive capsulitis were retrospectively analyzed. MR images were assessed for capsule and synovium thickness as well as the width of the axillary recess on oblique coronal fat-suppressed T1-weighted images and T2-weighted images, respectively. On oblique sagittal fat-suppressed T1-weighted images, the width of the rotator interval and the presence of abnormal tissue in the interval were evaluated. Significant differences were found between the two groups in capsule and synovium thickness on both sides of the recess on oblique coronal T2-weighted images (P=0.000), whereas thickness on the humeral aspect showed no significant difference on oblique coronal fat-suppressed T1-weighted images (P=0.109). On oblique coronal T2-weighted images, a cut-off value of 3-mm thickness gave the highest diagnostic accuracy for adhesive capsulitis with sensitivity, specificity, and accuracy of 79% (11/14), 100% (14/14), and 89% (25/28) at the humeral side and 93% (13/14), 86% (12/14), and 89% (25/28) at the glenoid side, respectively. There were significant differences in rotator interval width, presence of abnormal tissue in the rotator interval, and axillary recess width between the two groups (P<0.05). Thickness of capsule and synovium of the axillary recess greater than 3 mm is a practical MR criterion for diagnosing adhesive capsulitis when measured on oblique coronal T2-weighted MR arthrography images without fat suppression. The presence of abnormal tissue in the rotator interval showed high sensitivity but rather low specificity.


Shoulder Magnetic resonance Arthrography Adhesive capsulitis Frozen shoulder 


  1. 1.
    Hannafin JA, Chiaia TA (2000) Adhesive capsulitis. A treatment approach. Clin Orthop 372:95–109Google Scholar
  2. 2.
    Neviaser RJ, Neviaser TJ (1987) The frozen shoulder. Diagnosis and management. Clin Orthop 223:59–64Google Scholar
  3. 3.
    Neviaser TJ (1987) Adhesive capsulitis. Orthop Clin North Am 18:439–443Google Scholar
  4. 4.
    Emig EW, Schweitzer ME, Karasick D, Lubowitz J (1995) Adhesive capsulitis of the shoulder: MR diagnosis. Am J Roentgenol 164:1457–1459Google Scholar
  5. 5.
    Connell D, Padmanabhan R, Buchbinder R (2002) Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol 12:2100–2106Google Scholar
  6. 6.
    Manton GL, Schweitzer ME, Weishaupt D, Karasick D (2001) Utility of MR arthrography in the diagnosis of adhesive capsulitis. Skelet Radiol 30:326–230Google Scholar
  7. 7.
    Lee MH, Ahn JM, Muhle C et al. (2003) Adhesive capsulitis of the shoulder: diagnosis using magnetic resonance arthrography, with arthroscopic findings as the standard. J Comput Assist Tomogr 27:901–906Google Scholar
  8. 8.
    Bunker TD, Anthony PP (1995) The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 77:677–683Google Scholar
  9. 9.
    Neviaser J (1945) Adhesive capsulitis of the shoulder: study of pathologic findings in periarthritis of the shoulder. J Bone Joint Surg 27:211–222Google Scholar
  10. 10.
    Lundberg BJ (1969) The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 119:1–59Google Scholar
  11. 11.
    Elentuck D, Palmer WE (2004) Direct magnetic resonance arthrography. Eur Radiol 14:1956–1967Google Scholar
  12. 12.
    Kreitner KF, Loew R, Runkel M, Zollner J, Thelen M (2003) Low-field MR arthrography of the shoulder joint: technique, indications, and clinical results. Eur Radiol 13:320–329Google Scholar
  13. 13.
    Neviaser TJ (1980) Arthrography of the shoulder. Orthop Clin North Am 11:205–217Google Scholar
  14. 14.
    Ekelund AL, Rydell N (1992) Combination treatment for adhesive capsulitis of the shoulder. Clin Orthop 282:105–109Google Scholar
  15. 15.
    Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M (2004) Frozen shoulder: MR arthrographic findings. Radiology 233:486–492Google Scholar
  16. 16.
    Ozaki J, Nakagawa Y, Sakurai G, Tamai S (1989) Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am 71:1511–1515Google Scholar
  17. 17.
    Mellado JM, Calmet J, Domenech S, Sauri A (2003) Clinically significant skeletal variations of the shoulder and the wrist: role of MR imaging. Eur Radiol 13:1735–1743Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Joon-Yong Jung
    • 1
  • Won-Hee Jee
    • 1
  • Ho Jong Chun
    • 1
  • Yang-Soo Kim
    • 2
  • Yang Guk Chung
    • 2
  • Jung-Man Kim
    • 2
  1. 1.Department of Radiology, Kangnam St. Mary's HospitalThe Catholic University of KoreaSeoulSouth Korea
  2. 2.Department of Orthopedic Surgery, Kangnam St. Mary's HospitalThe Catholic University of KoreaSeoulSouth Korea

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