Skip to main content
Erschienen in: European Radiology 10/2013

01.10.2013 | Musculoskeletal

Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture

verfasst von: Paul Michelin, Yohann Delarue, Fabrice Duparc, Jean Nicolas Dacher

Erschienen in: European Radiology | Ausgabe 10/2013

Einloggen, um Zugang zu erhalten

Abstract

Objectives

The aim of this retrospective study was to measure the inferior glenohumeral capsule thickness of shoulders clinically affected by capsular contracture by comparison to the contralateral asymptomatic side.

Methods

Bilateral shoulder ultrasound (US) examinations of 20 patients with clinically or MRI proven unilateral capsular contracture were retrospectively assessed. Inferior capsule evaluation was performed with a transducer placed within the axilla in maximally abducted shoulders. Measurements were symmetrically performed orthogonally to the inferior glenohumeral ligament (IGHL) in the axial plane; the coronal plane was used to ensure the tension of the IGHL. The significance of any difference in thickening was assessed with the Mann–Whitney test.

Results

The average thickness was 4.0 mm in shoulders with capsular contracture vs. 1.3 mm in asymptomatic contralateral shoulders (P < 0.0001). Twenty per cent of patients with capsular contracture and inferior capsule thickness increase showed US features of other painful diseases of the rotator cuff.

Conclusion

The thickness of the inferior capsule is measurable through ultrasound examination and appears to be increased in shoulders with capsular contracture. Exploration of the inferior aspect of the shoulder joint could be added to shoulder US examination protocols for capsular contracture assessment even if other rotator cuff abnormalities are diagnosed by US.

Key Points

Ultrasound is increasingly used to diagnose shoulder problems.
The thickness of the inferior glenohumeral ligament is measurable in the axilla.
The inferior glenohumeral ligament appears thickened in shoulders with capsular contracture.
Capsular contracture ultrasound features can be associated with other rotator cuff problems.
Literatur
1.
Zurück zum Zitat Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA (2011) Current review of adhesive capsulitis. J Shoulder Elbow Surg 20:502–514PubMedCrossRef Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA (2011) Current review of adhesive capsulitis. J Shoulder Elbow Surg 20:502–514PubMedCrossRef
2.
Zurück zum Zitat Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR (2012) Frozen shoulder. J Bone Joint Surg Br 94:1–9PubMed Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR (2012) Frozen shoulder. J Bone Joint Surg Br 94:1–9PubMed
3.
Zurück zum Zitat Loyd JA, Loyd HM (1983) Adhesive capsulitis of the shoulder: arthrographic diagnosis and treatment. South Med J 76:879–883PubMedCrossRef Loyd JA, Loyd HM (1983) Adhesive capsulitis of the shoulder: arthrographic diagnosis and treatment. South Med J 76:879–883PubMedCrossRef
4.
Zurück zum Zitat Lundberg BJ (1969) The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 119:1–59PubMed Lundberg BJ (1969) The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl 119:1–59PubMed
5.
Zurück zum Zitat Emig EW, Schweitzer ME, Karasick D, Lubowitz J (1995) Adhesive capsulitis of the shoulder: MR diagnosis. AJR Am J Roentgenol 164:1457–1459PubMedCrossRef Emig EW, Schweitzer ME, Karasick D, Lubowitz J (1995) Adhesive capsulitis of the shoulder: MR diagnosis. AJR Am J Roentgenol 164:1457–1459PubMedCrossRef
6.
Zurück zum Zitat Sofka CM, Ciavarra GA, Hannafin JA, Cordasco FA, Potter HG (2008) Magnetic resonance imaging of adhesive capsulitis: correlation with clinical staging. HSS J 4:164–169PubMedCrossRef Sofka CM, Ciavarra GA, Hannafin JA, Cordasco FA, Potter HG (2008) Magnetic resonance imaging of adhesive capsulitis: correlation with clinical staging. HSS J 4:164–169PubMedCrossRef
7.
Zurück zum Zitat Ahn KS, Kang CH, Oh YW, Jeong WK (2012) Correlation between magnetic resonance imaging and clinical impairment in patients with adhesive capsulitis. Skeletal Radiol 41:1301–1308PubMedCrossRef Ahn KS, Kang CH, Oh YW, Jeong WK (2012) Correlation between magnetic resonance imaging and clinical impairment in patients with adhesive capsulitis. Skeletal Radiol 41:1301–1308PubMedCrossRef
8.
Zurück zum Zitat Lee JC, Sykes C, Saifuddin A, Connell D (2005) Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol 34:522–527PubMedCrossRef Lee JC, Sykes C, Saifuddin A, Connell D (2005) Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol 34:522–527PubMedCrossRef
9.
Zurück zum Zitat Homsi C, Bordalo-Rodrigues M, da Silva JJ, Stump XM (2006) Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool? Skeletal Radiol 35:673–678PubMedCrossRef Homsi C, Bordalo-Rodrigues M, da Silva JJ, Stump XM (2006) Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool? Skeletal Radiol 35:673–678PubMedCrossRef
10.
Zurück zum Zitat Ryu KN, Lee SW, Rhee YG, Lim JH (1993) Adhesive capsulitis of the shoulder joint: usefulness of dynamic sonography. J Ultrasound Med 12:445–449PubMed Ryu KN, Lee SW, Rhee YG, Lim JH (1993) Adhesive capsulitis of the shoulder joint: usefulness of dynamic sonography. J Ultrasound Med 12:445–449PubMed
11.
Zurück zum Zitat Kim I, Yi JH, Lee J, Bae JH, Lim JK, Yoon JP, Jeon IH (2012) Limited subacromial gliding of the supraspinatus tendon during dynamic ultrasonography can predict a decrease in capacity and MR arthrographic features of the shoulder joint. Eur Radiol 22:2365–2370PubMedCrossRef Kim I, Yi JH, Lee J, Bae JH, Lim JK, Yoon JP, Jeon IH (2012) Limited subacromial gliding of the supraspinatus tendon during dynamic ultrasonography can predict a decrease in capacity and MR arthrographic features of the shoulder joint. Eur Radiol 22:2365–2370PubMedCrossRef
12.
Zurück zum Zitat Ticker JB, Flatow EL, Pawluk RJ, Soslowsky LJ, Ratcliffe A, Arnoczky SP, Mow VC, Bigliani LU (2006) The inferior glenohumeral ligament: a correlative investigation. J Shoulder Elbow Surg 15:665–674PubMedCrossRef Ticker JB, Flatow EL, Pawluk RJ, Soslowsky LJ, Ratcliffe A, Arnoczky SP, Mow VC, Bigliani LU (2006) The inferior glenohumeral ligament: a correlative investigation. J Shoulder Elbow Surg 15:665–674PubMedCrossRef
13.
Zurück zum Zitat Gondim Teixeira PA, Balaj C, Chanson A, Lecocq S, Louis M, Blum A (2012) Adhesive capsulitis of the shoulder: value of inferior glenohumeral ligament signal changes on T2-weighted fat-saturated images. Am J Roentgenol. 198:W589-w596 Gondim Teixeira PA, Balaj C, Chanson A, Lecocq S, Louis M, Blum A (2012) Adhesive capsulitis of the shoulder: value of inferior glenohumeral ligament signal changes on T2-weighted fat-saturated images. Am J Roentgenol. 198:W589-w596
14.
Zurück zum Zitat Mengiardi B, Pfirrmann CWA, Gerber C, Hodler J, Zanetti M (2004) Frozen shoulder: MR arthrographic findings. Radiology 233:486–492PubMedCrossRef Mengiardi B, Pfirrmann CWA, Gerber C, Hodler J, Zanetti M (2004) Frozen shoulder: MR arthrographic findings. Radiology 233:486–492PubMedCrossRef
15.
Zurück zum Zitat Rodeo SA, Hannafin JA, Tom J, Warren RF, Wickiewicz TL (1997) Immunolocalization of cytokines and their receptors in adhesive capsulitis of the shoulder. J Orthop Res 15:427–436 Rodeo SA, Hannafin JA, Tom J, Warren RF, Wickiewicz TL (1997) Immunolocalization of cytokines and their receptors in adhesive capsulitis of the shoulder. J Orthop Res 15:427–436
16.
Zurück zum Zitat Bunker TD, Esler CN (1995) Frozen shoulder and lipids. J Bone Joint Surg Br 77:684–686PubMed Bunker TD, Esler CN (1995) Frozen shoulder and lipids. J Bone Joint Surg Br 77:684–686PubMed
17.
Zurück zum Zitat Bunker TD, Reilly J, Baird KS, Hamblen DL (2000) Expression of growth factors, cytokines and matrix metalloproteinases in frozen shoulder. J Bone Joint Surg Br 82:768–773PubMedCrossRef Bunker TD, Reilly J, Baird KS, Hamblen DL (2000) Expression of growth factors, cytokines and matrix metalloproteinases in frozen shoulder. J Bone Joint Surg Br 82:768–773PubMedCrossRef
18.
Zurück zum Zitat Bulgen DY, Binder A, Hazleman BL, Park JR (1982) Immunological studies in frozen shoulder. J Rheumatol 9:893–898PubMed Bulgen DY, Binder A, Hazleman BL, Park JR (1982) Immunological studies in frozen shoulder. J Rheumatol 9:893–898PubMed
19.
Zurück zum Zitat Bunker TD, Anthony PP (1995) The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 77:677–683PubMed Bunker TD, Anthony PP (1995) The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 77:677–683PubMed
20.
Zurück zum Zitat Ryu JD, Kirpalani PA, Kim JM, Nam KH, Han CW, Han SH (2006) Expression of vascular endothelial growth factor and angiogenesis in the diabetic frozen shoulder. J Shoulder Elbow Surg 15:679–685PubMedCrossRef Ryu JD, Kirpalani PA, Kim JM, Nam KH, Han CW, Han SH (2006) Expression of vascular endothelial growth factor and angiogenesis in the diabetic frozen shoulder. J Shoulder Elbow Surg 15:679–685PubMedCrossRef
21.
22.
Zurück zum Zitat Klauser AS et al (2012) Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. Eur Radiol 22:1140–1148PubMedCrossRef Klauser AS et al (2012) Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. Eur Radiol 22:1140–1148PubMedCrossRef
23.
Zurück zum Zitat Edelson JG, Taitz C, Grishkan A (1991) The coracohumeral ligament. Anatomy of a substantial but neglected structure. J Bone Joint Surg Br 73:150–153PubMed Edelson JG, Taitz C, Grishkan A (1991) The coracohumeral ligament. Anatomy of a substantial but neglected structure. J Bone Joint Surg Br 73:150–153PubMed
24.
Zurück zum Zitat Lefevre-Colau MM et al (2005) Magnetic resonance imaging of shoulders with idiopathic adhesive capsulitis: reliability of measures. Eur Radiol 15:2415–2422PubMedCrossRef Lefevre-Colau MM et al (2005) Magnetic resonance imaging of shoulders with idiopathic adhesive capsulitis: reliability of measures. Eur Radiol 15:2415–2422PubMedCrossRef
Metadaten
Titel
Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture
verfasst von
Paul Michelin
Yohann Delarue
Fabrice Duparc
Jean Nicolas Dacher
Publikationsdatum
01.10.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2874-2

Weitere Artikel der Ausgabe 10/2013

European Radiology 10/2013 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.