Abdalla Y. Skaf MD, Abstract Co-Author: Nothing to Disclose

Rodrigo O. Carvalho de Aguiar MD, Presenter: Nothing to Disclose

Jader Jose Silva MD, Abstract Co-Author: Nothing to Disclose

Renata La Rocca Vieira MD, Abstract Co-Author: Nothing to Disclose

Luis Pecci Neto MD, Abstract Co-Author: Nothing to Disclose

Wanda Iwakami Caldana MD, Abstract Co-Author: Nothing to Disclose

To evaluate diferent MR imaging fingings of adhesive capsulitis and correlate it with the clinical stages of disease.

A prospective study of 3515 shoulder MRI in 2 years period (april 2004-2006)demonstrated 182 patients with clinical evidence of adhesive capsulitis. These cases were separated clinically in inflamatory phase (phase 1), adhesive phase (phase 2) and recovering/late phase (phase 3). One blinded musculoskeletal radiologist evaluated the obliteration of rotator interval fat pad, thickening of coracoumeral ligament > 4mm , capsular thickening at the rotator interval > 7mm, bluring and high signal of pericapsular structures and correlated it with the clinical phase. The MR protocol included sagital T1 and coronal, sagittal and axial T2 with fat saturation. Intravenous gadolinium injection was performed in 87 patients.

5,17% (182/3515)of patients presented adhesive capsulitis.46,2%(84/182)were classified in the inflamatory phase, 39,5% (72/182)in adhesive phase and 14,3%(26/182)in late phase. Thickening of coracoumeral ligament > 4mm was seen in 56,6%(93/182)patients, 27,4%(23/84)in phase 1, 66,6%(48/72)in phase 2 and 84,1% (22/26) in phase 3. Rotator interval capsular thickenig was demonstrated in 50,5% (92/182), 33,3%(28/84)in phase 1, 63,8%(46/72)in phase 2 and 69,2(18/26)in phase 3. Obliteration of the rotator interval fat pad was seen in 48,3%(88/182), 42,8%(36/84)in phase 1, 43,6%(31/72)in phase 2 and 42,3%(11/26)in phase 3. Bluring and high signal of pericapsular structures was seen in 81,3% (148/182), 95,2%(80/84)in phase 1, 81,9%(59/72)in phase 2 and 34,6(9/26)in phase 3.

Bluring and high signal of pericapsular strutures occurs in the inflamatory and adhesive phase, while capsular and acromioumeral ligament thickening is more common in the adhesive and late phase of disease.

There are different findings in different stages of adhesive capsulitis. The radiologis should be aware of it and do not expect that all findings appear togheter at the same patient.

Skaf, A, Aguiar, R, Silva, J, Vieira, R, Neto, L, Caldana, W, Correlation of MR Imaging Findings and Clinical Stages of Adhesive Capsulitis.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015426.html