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KMID : 0948920150140020087
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Clinical Pain
2015 Volume.14 No. 2 p.87 ~ p.92
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Feasibility of Contrast-Enhanced Magnetic Resonance Imaging for Representing Decreased Joint Volume in Adhesive Capsulitis of Shoulder
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Lee Yong-Taek
Yoon Kyung-Jae
Lee Joon-Youn
Lee Jung-Sang
Park Hee-Jin
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Abstract
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Objective: Conventional arthrography has been advocated as the gold standard to diagnose adhesive capsulitis by showing the decreased capacity of the shoulder joint (＜10 ml). The purpose of this study is to investigate the feasibility of quantitatively measured contrast-enhanced magnetic resonance imaging (CE-MRI) for representing decreased shoulder joint volume (＜10 ml).
Method: Twenty-eight patients who were treated with sono-guided intra-articular corticosteroid injection were included in the adhesive capsulitis group. Inclusion criteria were (a) clinical diagnosis of adhesive capsulitis; (b) shoulder joint volume ＜10 ml, which was measured during sono-guided intra-articular injection; and (c) presence of shoulder CE-MRI. The control group consisted of nine shoulders (seven patients) without any clinical sign of adhesive capsulitis. Thickness of enhancement on CE-MRI was measured at the axillary recess and rotator interval of the shoulder. Groups were compared by analysis of covariance to adjust for age.
Results: CE-MRI revealed very significant differences of enhancement between the two groups. The adjusted mean thickness of enhancements measured at the axillary recess (p=0.00) and rotator interval (p=0.00) in the adhesive capsulitis group were significantly greater than that in the control group, respectively.
Conclusion: Quantitatively measured enhancements at the axillary recess or rotator interval on CE-MRI appear to represent decreased shoulder joint volume. Therefore, CE-MRI could be helpful to diagnose adhesive capsulitis by representing capsular pathology, and aid in the selection of treatment options targeting the joint capsule, such as intra-articular corticosteroid injection with or without capsular distension and arthroscopic capsular release.
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KEYWORD
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Contrast-enhanced Magnetic Resonance Imaging, Shoulder, Adhesive capsulitis, Ultrasonography
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