Emig E W, Schweitzer M E, Karasick D, Lubowitz J
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
AJR Am J Roentgenol. 1995 Jun;164(6):1457-9. doi: 10.2214/ajr.164.6.7754892.
Adhesive capsulitis is a clinical syndrome of pain and severely decreased joint motion ("frozen shoulder") caused by thickening and contraction of the joint capsule and synovium. Although arthrographic criteria for the diagnosis have been described, to our knowledge, the MR characteristics have not been reported. Accordingly, we studied the MR findings in 10 patients with this syndrome.
MR images of 25 subjects were included in the study. Nine had adhesive capsulitis documented by arthrography, and one had adhesive capsulitis proved at surgery. The MR findings in these patients were compared with those of 15 asymptomatic volunteers. Images were assessed for thickness of the joint capsule and synovium, for thickness of the coracohumeral ligament, and for volume of articular fluid. Capsule and synovium thickness was measured adjacent to the axillary recess. The volume of intraarticular fluid was calculated from direct measurements of the axillary recess and biceps tendon sheath. The rotator cuff interval was qualitatively evaluated for the presence of abnormal tissue.
Thickening of capsule and synovium on MR images was characteristic of adhesive capsulitis, with a significant difference between mean thickness in patients with adhesive capsulitis (5.2 mm) and in asymptomatic volunteers (2.9 mm) (p < .01). Capsule and synovium thickness greater than 4 mm was a specific (95%) and sensitive (70%) criterion for the diagnosis of adhesive capsulitis. There was no significant difference in volume of articular fluid or thickness of the coracohumeral ligament between patients with adhesive capsulitis and asymptomatic volunteers (p > .5). The rotator cuff interval was not useful for assessing changes of adhesive capsulitis.
Joint capsule and synovium thickness greater than 4 mm is a useful MR criterion for the diagnosis of adhesive capsulitis. The volume of articular fluid seen on MR images is not significantly diminished in patients with adhesive capsulitis.
粘连性关节囊炎是一种因关节囊和滑膜增厚及挛缩导致疼痛和关节活动严重受限（“冻结肩”）的临床综合征。尽管已经描述了用于诊断的关节造影标准，但据我们所知，其磁共振成像（MR）特征尚未见报道。因此，我们研究了10例该综合征患者的MR表现。
本研究纳入了25名受试者的MR图像。其中9例经关节造影证实为粘连性关节囊炎，1例经手术证实为粘连性关节囊炎。将这些患者的MR表现与15名无症状志愿者的表现进行比较。评估图像上关节囊和滑膜的厚度、喙肱韧带的厚度以及关节液的体积。在腋窝隐窝附近测量关节囊和滑膜的厚度。关节内液体的体积通过直接测量腋窝隐窝和肱二头肌肌腱鞘来计算。对旋转袖间隙进行定性评估，以确定是否存在异常组织。
MR图像上关节囊和滑膜增厚是粘连性关节囊炎的特征，粘连性关节囊炎患者的平均厚度（5.2 mm）与无症状志愿者的平均厚度（2.9 mm）之间存在显著差异（p <.01）。关节囊和滑膜厚度大于4 mm是诊断粘连性关节囊炎的特异度（95%）和敏感度（70%）均较高的标准。粘连性关节囊炎患者与无症状志愿者之间的关节液体积或喙肱韧带厚度无显著差异（p >.5）。旋转袖间隙对评估粘连性关节囊炎的变化无用。
关节囊和滑膜厚度大于4 mm是诊断粘连性关节囊炎有用的MR标准。粘连性关节囊炎患者MR图像上所见的关节液体积无明显减少。
