The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Prevalence and Correlation between MRI Findings and Outcome of Conservative Treatment in Primary Idiopathic Frozen Shoulder

Document Type : RESEARCH PAPER

Authors
Mohammad Reza Guity 1
Furqan Khan 1
Masoumeh Gity 2
Hossein Sheidaie 3
Leila Aghaghazvini 4
1 Tehran University of Medical Sciences · Department of Orthopedics, Tehran, Iran
2 Department of Radiology, Medical Imaging Center, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Radiology, Imam hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
4 Department of Radiology, Shariati Hospital, MIRC(Musculoskeletal Imaging Research Center) Tehran University of Medical Sciences, Tehran, Iran
10.22038/abjs.2023.73913.3423
Abstract
Objectives: Primary idiopathic frozen shoulder (FS) causes pain and stiffness in the shoulder joint. Over 
time, this disease causes restriction of shoulder motion. We undertook this study to evaluate possible 
correlation of MRI findings with outcome of conservative management in FS.
Methods: A total of 65 cases participated in prospective cohort study. The correlation of MRI findings obtained 
before commencing the treatment with outcome of non-operative management (Mean of ROM, VAS, SST and OSS) 
was evaluated.
Results: Anterior extracapsular edema significantly correlated with FF, EXR, VAS (a) and OSS. The effusion in 
humeral side of axillary recess significantly correlated with ROM restriction in ABD, EXR. Capsular thickness of 
glenoid portion showed good significance with FF, ABD, VAS (a) and OSS. Increased thickness of CHL showed 
negative correlation with improvement of EXR (P=0.049) (r=-0.617). Thickening of IGHL showed negative 
correlation with improvement of ABD (p=0.005 r=-0.862) and FF (p=0.007 r=-0.831). Mean Height of Axillary recess 
(HAR) was 7.2mm (3.5-11mm). HAR showed negative correlation with VAS pain scale (P=0.036) (r=-0.682) and 
OSS (P=0.038) (r=-0.668)
Conclusion: Thickness of the joint capsule and effusion at the axillary fold are important factors for refractory frozen 
shoulder. We can recommend MRI for refractive cases and low threshold of expectation can be set for conservative 
management in patients with above findings.
 Level of evidence: III
Keywords
Adhesive capsulitis
Conservative treatment
MRI
Primary idiopathic frozen shoulder (FS)
Range of motion
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 4
April 2024
Pages 275-282

  • Receive Date 24 July 2023
  • Revise Date 15 January 2024
  • Accept Date 13 December 2023