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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-10-2017 | Shoulder

Correlations of magnetic resonance imaging findings with clinical symptom severity and prognosis of frozen shoulder

Authors: Jong Pil Yoon, Seok Won Chung, Byung Joo Lee, Hyung Sup Kim, Jae Hyuck Yi, Hyun-Joo Lee, Won-Ju Jeong, Sung Gyu Moon, Kyung-Soo Oh, Seok Tae Yoon

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2017

Abstract

Purpose

To evaluate the correlation between indirect magnetic resonance (MR) arthrographic imaging findings and the clinical symptoms and prognosis of patients with frozen shoulder.

Methods

Indirect MR arthrography was performed for 52 patients with primary frozen shoulder (mean age 55.1 ± 9.0 years) and 52 individuals without frozen shoulder (mean age 53.1 ± 10.7 years); capsular thickening and enhancement of the axillary recess as well as soft tissue thickening of the rotator interval were evaluated. Clinical symptom severity was assessed using the Visual Analogue Scale for Pain (VAS Pain), simple shoulder test (SST), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM). At 6-month follow-up, we evaluated whether MR arthrography findings correlated with the clinical symptoms and prognosis.

Results

Capsular thickening and enhancement of the axillary recess as well as soft tissue thickening of the rotator interval were significantly greater in the patient group than in the controls (p < 0.001). Capsular thickening of the axillary recess did not correlate with clinical symptoms or ROM (n.s.); however, capsular enhancement correlated with clinical symptom severity according to VAS Pain (p = 0.005), SST (p = 0.046), and ASES scores (p = 0.009). Soft tissue thickening of the rotator interval did not correlate with clinical symptom severity, but was associated with external rotation limitation (p = 0.002). However, none of the parameters correlated with clinical symptoms at 6-month follow-up.

Conclusions

Indirect MR arthrography provided ancillary findings, especially with capsular enhancement, for evaluating clinical symptom severity of frozen shoulder, but did not reflect the prognosis. MR findings in frozen shoulder should not replace clinical judgments regarding further prognosis and treatment decisions.

Level of evidence

IV.

Barakat K (2013) Correlation between pain and arthroscopic features of synovitis: a logical approach to verify correlations of TMJ pain Tanta. Dent J 10(3):168–172

Carrillon Y, Noel E, Fantino O, Perrin-Fayolle O, Tran-Minh VA (1999) Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. Rev Rhum Engl Ed 66(4):201–206PubMed

Chung SW, Huong CB, Kim SH, Oh JH (2013) Shoulder stiffness after rotator cuff repair: risk factors and influence on outcome. Arthroscopy 29(2):290–300. doi:10.1016/j.arthro.2012.08.023 CrossRefPubMed

Chung SW, Park JS, Kim SH, Shin SH, Oh JH (2012) Quality of life after arthroscopic rotator cuff repair: evaluation using SF-36 and an analysis of affecting clinical factors. Am J Sports Med 40(3):631–639. doi:10.1177/0363546511430309 CrossRefPubMed

Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

Dias R, Cutts S, Massoud S (2005) Frozen shoulder. BMJ 331(7530):1453–1456. doi:10.1136/bmj.331.7530.1453 CrossRefPubMedPubMedCentral

Emig EW, Schweitzer ME, Karasick D, Lubowitz J (1995) Adhesive capsulitis of the shoulder: MR diagnosis. AJR Am J Roentgenol 164(6):1457–1459. doi:10.2214/ajr.164.6.7754892 CrossRefPubMed

Escolar DM, Henricson EK, Mayhew J, Florence J, Leshner R, Patel KM, Clemens PR (2001) Clinical evaluator reliability for quantitative and manual muscle testing measures of strength in children. Muscle Nerve 24(6):787–793. doi:10.1002/mus.1070 CrossRefPubMed

Fallahi F, Green N, Gadde S, Jeavons L, Armstrong P, Jonker L (2013) Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology. Skeletal Radiol 42(9):1225–1233. doi:10.1007/s00256-013-1644-1 CrossRefPubMedPubMedCentral

10.

Flannigan B, Kursunoglu-Brahme S, Snyder S, Karzel R, Del Pizzo W, Resnick D (1990) MR arthrography of the shoulder: comparison with conventional MR imaging. AJR Am J Roentgenol 155(4):829–832. doi:10.2214/ajr.155.4.2119117 CrossRefPubMed

11.

Hand C, Clipsham K, Rees JL, Carr AJ (2008) Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 17(2):231–236. doi:10.1016/j.jse.2007.05.009 CrossRefPubMed

12.

Hand GC, Athanasou NA, Matthews T, Carr AJ (2007) The pathology of frozen shoulder. J Bone Joint Surg Br 89(7):928–932. doi:10.1302/0301-620X.89B7.19097 CrossRefPubMed

13.

Herold T, Bachthaler M, Hamer OW, Hente R, Feuerbach S, Fellner C, Strotzer M, Lenhart M, Paetzel C (2006) Indirect MR arthrography of the shoulder: use of abduction and external rotation to detect full- and partial-thickness tears of the supraspinatus tendon. Radiology 240(1):152–160. doi:10.1148/radiol.2393050453 CrossRefPubMed

14.

Jung JY, Jee WH, Chun HJ, Kim YS, Chung YG, Kim JM (2006) Adhesive capsulitis of the shoulder: evaluation with MR arthrography. Eur Radiol 16(4):791–796. doi:10.1007/s00330-005-0020-5 CrossRefPubMed

15.

Kerimoglu U, Aydingoz U, Atay OA, Ergen FB, Kirkpantur A, Arici M (2007) Magnetic resonance imaging of the rotator interval in patients on long-term hemodialysis: correlation with the range of shoulder motions. J Comput Assist Tomogr 31(6):970–975. doi:10.1097/RCT.0b013e31805930f4 CrossRefPubMed

16.

L’Insalata JC, Warren RF, Cohen SB, Altchek DW, Peterson MG (1997) A self-administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Joint Surg Am 79(5):738–748CrossRefPubMed

17.

Lefevre-Colau MM, Drape JL, Fayad F, Rannou F, Diche T, Minvielle F, Demaille-Wlodyka S, Mayoux-Benhamou MA, Fermanian J, Poiraudeau S, Revel M (2005) Magnetic resonance imaging of shoulders with idiopathic adhesive capsulitis: reliability of measures. Eur Radiol 15(12):2415–2422. doi:10.1007/s00330-005-2830-x CrossRefPubMed

18.

Loveday DT, Johnston P, Arthur A, Tytherleigh-Strong GM (2009) Frozen shoulder: a clinical review. Br J Hosp Med (Lond) 70(5):276–278CrossRef

19.

Lubiecki M, Carr A (2007) Frozen shoulder: past, present, and future. J Orthop Surg (Hong Kong) 15(1):1–3CrossRef

20.

Mengiardi B, Pfirrmann CW, Gerber C, Hodler J, Zanetti M (2004) Frozen shoulder: MR arthrographic findings. Radiology 233(2):486–492. doi:10.1148/radiol.2332031219 CrossRefPubMed

21.

Michener LA, McClure PW, Sennett BJ (2002) American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg 11(6):587–594. doi:10.1067/mse.2002.127096 CrossRefPubMed

22.

Neviaser JS (1980) Adhesive capsulitis and the stiff and painful shoulder. Orthop Clin North Am 11(2):327–331PubMed

23.

Oh JH, Kim SH, Lee HK, Jo KH, Bin SW, Gong HS (2008) Moderate preoperative shoulder stiffness does not alter the clinical outcome of rotator cuff repair with arthroscopic release and manipulation. Arthroscopy 24(9):983–991. doi:10.1016/j.arthro.2008.06.007 CrossRefPubMed

24.

Oh JH, Oh CH, Choi JA, Kim SH, Kim JH, Yoon JP (2011) Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study. J Shoulder Elbow Surg 20(7):1034–1040. doi:10.1016/j.jse.2011.04.029 CrossRefPubMed

25.

Pal B, Anderson J, Dick WC, Griffiths ID (1986) Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol 25(2):147–151CrossRefPubMed

26.

Scanzello CR, McKeon B, Swaim BH, DiCarlo E, Asomugha EU, Kanda V, Nair A, Lee DM, Richmond JC, Katz JN, Crow MK, Goldring SR (2011) Synovial inflammation in patients undergoing arthroscopic meniscectomy: molecular characterization and relationship to symptoms. Arthritis Rheum 63(2):391–400. doi:10.1002/art.30137 CrossRefPubMedPubMedCentral

27.

Schultheis A, Reichwein F, Nebelung W (2008) Frozen shoulder. Diagnosis and therapy. Orthopade 37(11):1065–72. doi:10.1007/s00132-008-1305-6 CrossRefPubMed

28.

Sofka CM, Ciavarra GA, Hannafin JA, Cordasco FA, Potter HG (2008) Magnetic resonance imaging of adhesive capsulitis: correlation with clinical staging. HSS J 4(2):164–169. doi:10.1007/s11420-008-9088-1 CrossRefPubMedPubMedCentral

29.

Song KD, Kwon JW, Yoon YC, Choi SH (2011) Indirect MR arthrographic findings of adhesive capsulitis. AJR Am J Roentgenol 197(6):W1105–W1109. doi:10.2214/AJR.10.6099 CrossRefPubMed

30.

Steinbach LS, Palmer WE, Schweitzer ME (2002) Special focus session. MR arthrography. Radiographics 22(5):1223–1246. doi:10.1148/radiographics.22.5.g02se301223 CrossRefPubMed

31.

Tamai K, Yamato M (1997) Abnormal synovium in the frozen shoulder: a preliminary report with dynamic magnetic resonance imaging. J Shoulder Elbow Surg 6(6):534–543CrossRefPubMed

32.

Wiley AM (1991) Arthroscopic appearance of frozen shoulder. Arthroscopy 7(2):138–143. doi:10.1016/0749-8063(91)90098-I CrossRefPubMed

33.

Wolf EMCW (2010) The external rotation test in the diagnosis of adhesive capsulitis. Orthopedics 33(5):303. doi:10.3928/01477447-20100329-11

Title: Correlations of magnetic resonance imaging findings with clinical symptom severity and prognosis of frozen shoulder
Authors: Jong Pil Yoon
Seok Won Chung
Byung Joo Lee
Hyung Sup Kim
Jae Hyuck Yi
Hyun-Joo Lee
Won-Ju Jeong
Sung Gyu Moon
Kyung-Soo Oh
Seok Tae Yoon
Publication date: 01-10-2017
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3887-y

At a glance: The STEP trials

Springer Medicine

Correlations of magnetic resonance imaging findings with clinical symptom severity and prognosis of frozen shoulder

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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