Radiological Modalities in Frozen Shoulder Diagnosis: Role of MRI and US

Abstract

Abstract Background The prevalence of frozen shoulder in the general population is 2–5 %, with most patients over 40 years of age and with women slightly more affected than men. Contralateral shoulder involvement is uncommon. Diagnostic imaging of the shoulder joint may be achieved with a number of modalities, including g plain x-ray, ultrasound, conventional arthrography, magnetic resonance imaging (MRI) and MR arthrography. Objective The objective is to examine the association between clinical features (stages) and MRI findings in adhesive capsulitis of the shoulder. Methods During this study, 28 patients with frozen shoulder were enrolled, after consenting each of them and subjected to MRI and US examination. The accuracy of magnetic resonance imaging versus ultrasound in early detection of frozen shoulder and exclusion of it among other painful shoulder cases was assessed. Results In detection of thickened inferior glenohumeral ligament (IGHL), the accuracy of ultrasound was 71.4%, sensitivity 65.2% and specificity 100.0% and MRI was statistically significant more accurate than ultrasound. As regard thickened coracohumeral ligament (CHL), the accuracy of ultrasound was 57.1%, sensitivity 66.7% and specificity 40.0%. Also, as regard altered signal or thickening within rotator interval, the accuracy of ultrasound was 71.4%, sensitivity 78.9% and specificity 55.6% with no significant between MRI and ultrasound. Finally the total accuracy of US in prediction of MRI findings was 78.6%, sensitivity 76.9% and specificity of 100.0%. Conclusion Ultrasound is advised to be used in assessment of cases shoulder stiffness rather than MRI. It is cheap, less invasive, accurate without radiation and suitable for all cases to them MRI is contraindicated. The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes, to assess our results and conclusion.