Early diagnosis of primary/idiopathic adhesive capsulitis: Can imaging contribute?

Abstract

Adhesive capsulitis is a frequently presenting shoulder disorder in musculoskeletal medicine. It is recognized as consisting of three stages, and is often difficult to diagnose in its early stage and differentiate from other shoulder disorders. Treatment of this disorder has been proposed to be dependant on the stage, with early treatment suggested to decrease the overall morbidity. Arguably therefore, recognition in this early stage is desirable. The purpose of this paper is to review the current evidence that may support the role of imaging facilitating a diagnosis of adhesive capsulitis and to discuss this in relation to the contemporary understanding of the pathology of this disorder. The emerging role of Doppler ultrasound in the diagnosis and management of inflammatory arthropathies is discussed, and in particular its potential to contribute to the early diagnosis of adhesive capsulitis. While the diagnosis of adhesive capsulitis is presently largely based on clinical examination, this review outlines the current and future role that radiology may be able to contribute to the clinical presentation.

Keywords:

• Adhesive capsulitis
• Diagnosis
• Shoulder
• Ultrasonography
• Magnetic resonance imaging

Acknowledgements

We thank Dr Mariola Wierna for reviewing the manuscript prior to submission and Mariken Osmotherly for the artwork.