Magnetic resonance imaging of the rotator interval in patients on long-term hemodialysis: correlation with the range of shoulder motions.

OBJECTIVE

To assess the rotator interval of patients on long-term hemodialysis with magnetic resonance imaging (MRI) for the presence of adhesive capsulitis and to correlate these findings with shoulder motions.

METHODS

Seventeen shoulders in 16 patients (mean age, 53.8 years) on hemodialysis (range of duration, 4-28 years) who had pain and limited range of shoulder motion underwent MRI. Rotator interval was inspected in 3 regions (subcoracoid area, above the subscapularis muscle, and around the biceps tendon) on sagittal magnetic resonance images with regard to increased nonfatty soft tissue intensity as none, mild, moderate, and marked. Magnetic resonance images were evaluated by 2 musculoskeletal radiologists with consensus. Ranges of motion for external and internal rotation and abduction and forward flexion were assessed either normal or mildly, moderately, and severely limited.

RESULTS

Increased nonfatty soft tissue intensity within the rotator interval fat was observed in 11 shoulders (65%). Very strong positive correlation was found between the limitation of external rotation and the presence of nonfatty soft tissue infiltrating all 3 areas of the rotator interval fat (rs, between 0.81 and 0.96; P < 0.001). Strong positive correlation was found between the hemodialysis duration and the presence of nonfatty soft tissue infiltrating all 3 areas of the rotator interval fat (rs, between 0.68 and 0.71; P <or= 0.002).

CONCLUSIONS

Long-term hemodialysis results in adhesive capsulitis-like MRI findings in the shoulder joint with nonfatty soft tissue infiltration in the rotator interval that is related to hemodialysis duration. The degree of MRI obliteration of the rotator interval fat strongly correlates with the range limitation of some shoulder motions.