Abstract
Objective
To determine the accessibility of the coracohumeral ligament (CHL) by ultrasound (US) and to determine CHL thickness in adhesive capsulitis of the shoulder.
Design and patients
US examinations were carried out in 498 consecutive shoulders of 306 individuals (194 women and 112 men), mean age 47.4 years (range 15–92 years), in order to identify and measure the maximum thickness of the CHL. The patients were divided into three study groups: asymptomatic shoulders (n=121), painful shoulders (n=360) and shoulders with arthrographic evidence of adhesive capsulitis (n=17). The mean maximal thickness of CHL was compared among the 3 study groups (non-parametric test of Kruskal–Wallis, p<0.05).
Results
The CHL was visualized in 92 out of 121 shoulders in the asymptomatic group (76.0%), in 227 out of 360 shoulders in the painful shoulder group (63.0%), and in 15 out of 17 shoulders in the adhesive capsulitis group (88.2%). The average thickness of the CHL was significantly greater in adhesive capsulitis (3 mm) than in the asymptomatic (1.34 mm) and painful (1.39 mm) shoulders. No significant difference was found between asymptomatic and painful shoulders.
Conclusion
CHL depiction can be achieved in a reasonable proportion of shoulders. A thickened CHL is suggestive of adhesive capsulitis. More studies are needed for clinical validation of these data.
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References
Codman EA. Tendinitis of the short rotators. In: Codman EA, ed. Ruptures of the supraspinatus tendon and other lesions on or about the subacromial bursa. Boston, Mass: Thomas Todd; 1934
Neviaser JS. Adhesive capsulitis of the shoulder (the frozen shoulder). Med Times 1962;90:783–807
Neviaser JS. Adhesive capsulitis and the stiff and painful shoulder. Orthop Clin North Am 1980;11:327–331
Zuckerman JD, Cuomo F. Frozen shoulder. In: Matsen FA, Fu FH, Hawkins RJ, (eds.) The shoulder: a balance of mobility and stability. Rosemont, Illinois: American Academy of Orthopaedic Surgeons; 1993pp 253–267
Uitvlugt G, Detrisac DA, Johnson LL, Austin MD, Johnson C. Arthroscopic observations before and after manipulation of frozen shoulder. Arthroscopy 1993;9:181–185
Neviaser JS. Adhesive capsulitis of the shoulder. J Bone Joint Surg Am 1945;27:211–222
Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 1995;77:677–683
Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg 2001; 10:353–357
Ozaki J, Nakagawa Y, Sakurai G, Tamai S. 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 1989;71:1511–1515
Neer CS 2nd, Satterlee CC, Dalsey RM, Flatow EL. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res 1992;182–185
Lequesne M, Dang N, Bensasson M, Mery C. Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder-hand syndrome. Scand J Rheumatol 1977;6:53–56
Kay NR, Slater DN. Fibromatoses and diabetes mellitus. Lancet 1981;2:303
Neviaser TJ. Arthrography of the shoulder. Orthop Clin North Am 1980;11:205–217
Emig EW, Schweitzer ME, Karasick D, Lubowitz J. Adhesive capsulitis of the shoulder: MR diagnosis. AJR Am J Roentgenol 1995;164:1457–1459
Carrillon Y, Noel E, Fantino O, Perrin-Fayolle O, Tran-Minh VA. Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. Rev Rhum Engl Ed 1999;66:201–206
Connell D, Padmanabhan R, Buchbinder R. Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol 2002;12:2100–2106
Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M Frozen. shoulder: MR arthrographic findings. Radiology 2004;233:486–492
Lee JC, Sykes C, Saifuddin A, Connell D. Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol 2005;34:522–527
Homsi C, Rodrigues MB, Silva JJ, Stump X, Morvan G. [Anomalous insertion of the pectoralis minor muscle: ultrasound findings]. J Radiol 2003;84:1007–1011
Ryu KN, Lee SW, Rhee YG, Lim JH. Adhesive capsulitis of the shoulder joint: usefulness of dynamic sonography. J Ultrasound Med 1993;12:445–449
van Holsbeeck M, Vanderschueren J, Wohlend J Shoulder. Sonography in adhesive capsulitis. In:83rd Annual Meeting of the Radiological Society of North America. Chicago, USA; 1997
Martinoli C, Bianchi S, Prato N, et al. US of the shoulder: non-rotator cuff disorders. Radiographics 2003;23:381–401; quiz 534
Martinoli C, Podestà R, Morag Y, Jacobson J, Miller B, Bianchi S. Ultrasound of the reflection pulley of the long biceps tendon. In:Annual Meeting of the Radiological Society of North America. Chicago, USA;2004
Ferrari DA. Capsular ligaments of the shoulder. Anatomical and functional study of the anterior superior capsule. Am J Sports Med 1990;18:20–24
Rouviére H. Anatomía humana descriptiva y topográfica. Madrid: Casa Editorial Bailly-Bailliere; 1959
Le Double A. Traité des variations du système musculaire de l'homme et de leur signification au point de vue de l’anthropologie zoologique. Paris: Schleicher Frères Editeurs; 1897
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Homsi, C., Bordalo-Rodrigues, M., da Silva, J.J. et al. Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool?. Skeletal Radiol 35, 673–678 (2006). https://doi.org/10.1007/s00256-006-0136-y
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DOI: https://doi.org/10.1007/s00256-006-0136-y