Adhesive capsulitis: Contrast-enhanced shoulder MRI findings

Purpose: Evaluation of contrast-enhanced magnetic resonance imaging (CE-MRI) findings in cases clinically diagnosed as adhesive capsulitis (AC). Methods: CE-MRI images of 12 cases diagnosed as AC (13 shoulder joints) and nine control cases were retrospectively evaluated. AC diagnosis was established based on the history and clinical symptoms. MR signal intensity changes in the axillary pouch, rotator interval, biceps anchor and anterior-posterior capsules were analysed with regard to the presence of abnormal soft tissue and contrast enhancement. Capsular and synovial thickening were measured in the axillary recess and rotator interval on coronal oblique CE T1-weighted images. Patient and control groups were compared by Fisher's exact and McNemar tests in terms of signal intensity changes and contrast enhancement in the described areas. Results: Comparison of the group with AC and the control group regarding intensity changes showed a statistically significant difference in the axillary pouch (P < 0.001). No significant difference was found in the rotator interval, biceps anchor and anterior-posterior capsules (P > 0.05). Comparison of AC and control groups in terms of contrast enhancement revealed statistically significant differences in the axillary pouch, rotator interval, biceps anchor and anterior-posterior capsules (P < 0.001). A significant difference was determined between the AC and control groups with regard to thickening in axillary pouch and rotator interval (P < 0.001). Conclusion: CE studies are useful for diagnosis of AC as it demonstrates thickening of specific soft-tissue areas like joint capsule and synovium.