Lee Jun-Gyu, Peo Hyungsun, Cho Jang-Hyuk, Cho Chul-Hyun, Kim Don-Kyu, Kim Du-Hwan
Department of Physical Medicine and Rehabilitation, College of Medicine, Chung-Ang University, Seoul 06973, Korea.
Department of Rehabilitation Medicine, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu 42601, Korea.
Diagnostics (Basel). 2021 May 18;11(5):898. doi: 10.3390/diagnostics11050898.
The diagnostic value of ultrasonography (US) for frozen shoulder (FS) is not well established. This study aimed to assess the diagnostic value of US measurement of inferior joint capsule (IJC) thickness and evaluate changes in the thickness of the IJC by US depending on arm position. A total of 71 patients with clinically diagnosed unilateral FS who underwent bilateral US measurement of the IJC were enrolled in this study. The US measurement of the IJC was performed with a linear transducer positioned around the anterior axillary line with the shoulder 40° abducted and with neutral rotation of the glenohumeral joint (neutral position). We also measured the IJC thickness in the externally rotated and internally rotated positions with the shoulder 40° abducted. In the neutral position, as well as in the internally rotated and externally rotated positions, the thickness of the IJC on US was significantly higher in the affected shoulder than that in the unaffected shoulder (all < 0.001). On both the affected and unaffected sides, the US thickness of the IJC in the neutral position was significantly higher than that in the externally rotated position ( < 0.001), but lower than that in the internally rotated position ( < 0.001). Regarding IJC thickness in the neutral position, a 3.2-mm cutoff value yielded the highest diagnostic accuracy for FS, with a sensitivity and specificity of 73.2% and 77.5%, respectively. The area under the curve for IJC thickness was 0.824 (95% confidence interval, 0.76-0.89). US measurement of the IJC in the neutral position yielded good diagnostic accuracy for FS. Because IJC thickness is affected by arm rotation, it is important to measure the IJC thickness in a standardized posture to ensure diagnostic value.
超声检查（US）对肩周炎（FS）的诊断价值尚未明确。本研究旨在评估超声测量肩关节下关节囊（IJC）厚度的诊断价值，并根据手臂位置评估超声测量的IJC厚度变化。本研究共纳入71例临床诊断为单侧FS且接受双侧IJC超声测量的患者。IJC的超声测量采用线性探头，置于腋前线周围，肩部外展40°，肱盂关节中立旋转（中立位）。我们还测量了肩部外展40°时外旋位和内旋位的IJC厚度。在中立位以及内旋位和外旋位，患侧肩部IJC的超声厚度均显著高于健侧肩部（均P<0.001）。在患侧和健侧，中立位IJC的超声厚度均显著高于外旋位（P<0.001），但低于内旋位（P<0.001）。关于中立位IJC厚度，3.2mm的截断值对FS的诊断准确性最高，敏感性和特异性分别为73.2%和77.5%。IJC厚度的曲线下面积为0.824（95%置信区间，0.76 - 0.89）。中立位IJC的超声测量对FS具有良好的诊断准确性。由于IJC厚度受手臂旋转影响，以标准化姿势测量IJC厚度以确保诊断价值很重要。
