[Adhesive capsulitis].

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Abstract

[Indexed for MEDLINE] 8. Rheumatol Ther. 2022 Apr;9(2):481-495. doi: 10.1007/s40744-021-00413-w. Epub 2021 Dec 23. Ultrasound Features of Adhesive Capsulitis. Stella SM(1)(2), Gualtierotti R(3), Ciampi B(4), Trentanni C(4)(5), Sconfienza LM(6), Del Chiaro A(4)(7), Pacini P(8), Miccoli M(9), Galletti S(10). Author information: (1)Department of Clinical and Experimental Medicine, Post-Graduate School of Sports Medicine, Santa Chiara University Hospital, University of Pisa, Via Roma 67, 56100, Pisa, Italy. smstella@alice.it. (2)Advanced Musculoskeletal Ultrasound, SIUMB School of Pisa, Pisa, Italy. smstella@alice.it. (3)Internal Medicine, Hemostasis and Thrombosis, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, University of Milan, Milan, Italy. (4)Advanced Musculoskeletal Ultrasound, SIUMB School of Pisa, Pisa, Italy. (5)Diagnostic Radiology Operational Unit, Castel Goffredo Institute IRCCS, Mantua, Italy. (6)Diagnostic and Interventional Radiology Operational Unit, Galeazzi Orthopedic Institute IRCCS, Milan, Italy. (7)Orthopedic and Traumatology Operating Unit, University of Pisa, Pisa, Italy. (8)Department of Radiological, Oncological and Anatomopathological Sciences, Umberto I General Hospital, La Sapienza University of Rome, Rome, Italy. (9)Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. (10)Advanced Musculoskeletal Ultrasound, SIUMB School of Bologna, Maggiore Hospital, Bologna, Italy. INTRODUCTION: Adhesive capsulitis (AC), which is characterised by shoulder pain and a limited range of motion (ROM), is usually diagnosed on the basis of clinical suspicion, with imaging only being used to exclude other causes of similar symptoms. The aim of this study was to identify and describe the typical ultrasound (US) features of AC in a group of patients with shoulder pain and stiffness. METHODS: This was a cross-sectional study of 1486 patients with AC in which two experienced US specialists examined the axillary pouch (AP), the coracohumeral ligament (CHL), the superior glenohumeral ligament (SGHL), and the long head of the biceps tendon (LHBT), and dynamically visualised the infraspinatus tendon during passive external rotation (PER) during a US evaluation of shoulder ROM. RESULTS: AC was confirmed in 106 patients (7.1%). Thickening of the AP of more than 4 mm was observed in 93.4% of the patients, whereas 6.6% showed AP thickening of less than 4 mm but more than 60% of the thickening in the contralateral shoulder. Effusion within the LHBT sheath was detected in 71% of the patients, and thickening of the CHL or SGHL in 88%. The dynamic study of the infraspinatus tendon showed reduced sliding with folding towards the joint capsule in 73% of cases, thus changing the tendon's profile from flat to concave during PER. The reduced tendon sliding was associated with a bouncing movement that returned the tendon to its baseline resting position in 41.5% of cases. CONCLUSIONS: We believe a sufficiently experienced US specialist can confirm a clinical diagnosis of AC by carrying out a comparative study of APs, evaluating the thickness of the CHL and SGHL, and detecting reduced sliding of the infraspinatus tendon. © 2021. The Author(s). DOI: 10.1007/s40744-021-00413-w PMCID: PMC8696249