Abstract
BackgroundRecent studies have demonstrated that the coracohumeral ligament (CHL) is shortened and thickened in a frozen shoulder. We analyzed the rate in CHL visualization between patients with frozen shoulder and normal volunteers using Magnetic Resonance Imaging (MRI) to determine the CHL thickness in the patients with a frozen shoulder.Methods and FindingsThere were 72 shoulder joints in 72 patients (50 femles and 22 males with a mean age of 53.5 years) with clinical evidence and MR imaging evidence of frozen shoulder. These were prospectively analyzed to identify and measure the maximum thickness of the CHL. The control group, which included 120 shoulder joints in 60 normal volunteer individuals (30 females and 30 males with a mean age of 50.5 years) was also referred for MR imaging. A chi-square test was used to analyze the data of the rate of CHL visualization between the patients with frozen shoulder and the control group. A two-way ANOVA was used to analyze the mean maximal thickness of CHL. The CHL was visualized in 110 out of 120 shoulders in the control group (91.7%), and in 57 out of 72 shoulders for the frozen shoulder group (79.2%), there was significant difference, using a chi-square test (P<0.05). The CHL was not visualized in 10 out of 120 shoulders in the control group (8.3%), and 15 out of 72 shoulders in the frozen shoulder group (20.8%), there was a significant difference (P<0.05). The CHL thickness (3.99±1.68 mm) in the patients with frozen shoulder was significantly greater than that thickness (3.08±1.32 mm) in the control group, using a two-way ANOVA (P<0.001). The CHL thickness (3.52±1.52 mm, n = 97) in the female shoulders was no significantly greater than that thickness (3.22±1.49 mm, n = 70) in the male shoulders, using a two-way ANOVA (P>0.05).ConclusionsMR Imaging is a satisfactory method for CHL depiction, and a thickened CHL is highly suggestive of frozen shoulder.
Highlights
Frozen shoulder, known as adhesive capsulitis, is a common condition involving scapulohumeral pain and loss of motion
MR Imaging is a satisfactory method for coracohumeral ligament (CHL) depiction, and a thickened CHL is highly suggestive of frozen shoulder
A percentage of shoulders of both the control group and the frozen shoulder group demonstrated that the complete obliteration of subcoracoid fat triangle and distinct fatty tissue surrounding the CHL had disappeared, so the CHL could not be measured for the sagittal oblique images
Summary
Known as adhesive capsulitis, is a common condition involving scapulohumeral pain and loss of motion. In 1934, Codman described the diagnosis of ‘‘frozen shoulder’’ as a condition characterized by pain and reduced range of motion in the affected shoulder [1]. We poorly grasp of the etiology and pathophysiology of frozen shoulder, and frozen shoulder is a poorly defined entity today. The current consensus regarding a definition of frozen shoulder comes from the American Shoulder and Elbow Surgeons and states it is ‘‘a condition of uncertain etiology characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.’’ [3,4]. We analyzed the rate in CHL visualization between patients with frozen shoulder and normal volunteers using Magnetic Resonance Imaging (MRI) to determine the CHL thickness in the patients with a frozen shoulder
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