Adhesive Capsulitis - MSK Radiology
• Thickened coracohumeral ligament (> 4 mm)
• Near circumferential T2-hyperintense pericapsular fluid-like signal consistent with capsular inflammation. Early stage finding.
• Thickened axillary pouch/inferior joint capsule (>3-4 mm thickness) with intrinsic edema-like signal suggesting inflammation.
• This is the region of the "subcoracoid triangle" which will have loss of fat signal with fibrotic T1-hypointense and T2-hyperintense signal. Triangle of tissue between the coracohumeral ligament, coracoid, and joint capsule.
• Adhesive capsulitis "frozen shoulder"
• Fibrosis occurs in the rotator interval with thickened and edematous joint capsule of the axillary recess.
• Fluid-like signal around and within the inferior joint capsule AND obliteration of rotator interval fat - THE MOST COMMON findings.
• Decreased range of motion from fibrotic capsule.
• Arthrogram: small axillary recess volume and limited contrast (<8-10 mL) in joint before extravasation.
• Capsular sprain: can look similar on MR with thickened and fluid-like signal in the inferior joint capsule. Results from trauma and usually rotator interval will be normal. Always in differential ifno history.
Dr. Donald von Borstel @DrvonBorstel
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