European Radiology

, Volume 29, Issue 2, pp 566–577 | Cite as

Systematic review and meta-analysis of magnetic resonance imaging features for diagnosis of adhesive capsulitis of the shoulder

  • Chong Hyun Suh
  • Seong Jong YunEmail author
  • Wook Jin
  • Sun Hwa Lee
  • So Young Park
  • Ji Seon Park
  • Kyung Nam Ryu



To perform a systematic review and meta-analysis to identify magnetic resonance imaging (MRI) features that will aid in the diagnosis of adhesive capsulitis of the shoulder (ACS) and provide a summary of the diagnostic accuracy of the identified features


The MEDLINE and EMBASE databases were searched for studies assessing the diagnostic accuracy of MRI features of ACS. Overlapping descriptors used to denote the same imaging finding in different studies were subsumed under a single feature. The pooled accuracy including the diagnostic odd ratios (DORs) with 95% confidence intervals (CIs) of the identified features was calculated using a bivariate random-effects model.


In total, 15 studies were included, and 74 overlapping descriptors were subsumed under six features. All six features were found to be informative for ACS diagnosis [coracohumeral ligament thickening: DOR, 13; 95% CI, 6-29; fat obliteration of the rotator interval (RI): DOR, 8; 95% CI, 3-24; RI enhancement: DOR, 44; 95% CI, 14-141; axillary joint capsule enhancement: DOR, 52; 95% CI, 27-98; inferior glenohumeral ligament (IGHL) hyperintensity: DOR, 31; 95% CI, 8-115; IGHL thickening: DOR, 28; 95% CI, 11-70]. The sensitivity and specificity of enhancement of the RI and axillary joint capsule and IGHL hyperintensity were > 80%.


Six informative MRI features for ACS diagnosis were identified in this study with RI and axillary joint capsule enhancement and IGHL hyperintensity showing the highest diagnostic accuracy. Informative features observed on non-arthrogram MRI can be as helpful as features observed on direct magnetic resonance arthrography for ACS diagnosis.

Key points

• Six informative MRI features for ACS diagnosis were identified (diagnostic odds ratio > 1).

• RI and axillary joint capsule enhancement and IGHL hyperintensity showed high sensitivities/specificities (> 80%).

• The use of non-arthrogram MRI is recommended for ACS diagnosis.


Meta-analysis Adhesive capsulitis of the shoulder Frozen shoulder Magnetic resonance imaging Data accuracy 



Adhesive capsulitis of the shoulder


Contrast enhanced


Coracohumeral ligament


Confidence interval


Diagnostic odds ratios


Inferior glenohumeral ligament


Rotator interval



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Seong Jong Yun, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Chong Hyun Suh, MD) has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because the nature of our study was a systemic review and meta-analysis.

Ethical approval

Institutional Review Board approval was not required because the nature of our study was a systematic review and meta-analysis.


• meta-analysis

• performed at one institution

Supplementary material

330_2018_5604_MOESM1_ESM.doc (11 mb)
ESM 1 (DOC 11294 kb)


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Radiology and Research Institute of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Radiology, Kyung Hee University Hospital at GangdongKyung Hee University School of MedicineSeoulRepublic of Korea
  3. 3.Department of Emergency Medicine, Sanggye Paik HospitalInje University College of MedicineSeoulRepublic of Korea
  4. 4.Department of RadiologyKyung Hee University HospitalSeoulRepublic of Korea

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