Measurement of Capsular Thickness in Magnetic Resonance Arthrography in Idiopathic Adhesive Capsulitis of Hip / 대한고관절학회지

PURPOSE: The clinical suspicion of idiopathic adhesive capsulitis of the hip (IACH) involves restricted range of motion and normal hip radiographs. The purpose of this study was to delineate the characteristic findings observed on magnetic resonance arthrography (MRA) by identifying the anatomical structures involved and their significance on clinical presentation of restricted range of motion. MATERIALS AND METHODS: We retrospectively evaluated MRA's of 46 hips (44 patients) who suffered hip pain from September 2006 to August 2012 in our hospital. Of those, 10 cases (8 patients) with clinical suspicion of IACH were compared to 20 normal hip cases (control group). To identify anatomical evidence of adhesive capsulitis in the MRA's of the IACH group, capsular thickness was measured superiorly, inferiorly, anteriorly and posteriorly, and compared to that of the randomly selected control group. RESULTS: Comparison of the MRA findings of the control group to that of the IACH group showed that there was a statistically significant increase in the mean thickness of the joint capsule superiorly and posteriorly (P<0.01), while comparison of examination findings revealed a statistically significant decrease in the mean range of motion (flexion 122.5degrees+/-5.5degrees/abduction 28.0degrees+/-2.8degrees/adduction 26.5degrees+/-2.4degrees/external rotation 30.5degrees+/-3.8degrees/internal rotation 25.5degrees+/-2.4degrees) in the IACH group. CONCLUSION: A change in the capsular thickness on MRA is a common finding in IACH patients with the increase more evident in the posterior and superior capsules than the anterior and inferior capsules.

Arthroscopic Management and Manipulation of Chronic Idiopathic Adhesive Capsulitis of the Shoulder / 대한정형외과학회잡지

PURPOSE: To describe the clinical efficacy of arthroscopic management followed by manipulation under anesthesia in chronic idiopathic adhesive capsulitis of the shoulder. MATERIALS AND METHODS: We evaluated nineteen patients who had a mean follow-up period of 3 years 1 month using the UCLA shoulder rating score. Arthroscopic management included an arthroscopic examination and debridement of the glenohumeral joint and the subacromial space, as well as the release of the rotator interval, the capsule, the glenohumeral ligaments and the inferior recess. Manipulation was performed after the arthroscopic procedures. RESULTS: Thirteen patients (68%) were completely free from pain. The forward elevation was im-proved from 97 degrees to 175 degrees, the abduction from 69 degrees to 170 degrees, the external rotation from 8 degrees to 51 degrees, and the internal rotation from the range of the buttock and the 3rd-4th lumbar spinous process to the level of the 7th-9th thoracic spinous process. The average UCLA shoulder rating score was 9 points before the operation and 34 points after the operation. CONCLUSION: Our clinical findings suggest that arthroscopic management followed by manipulation is an effective method for the treatment of chronic idiopathic adhesive capsulitis of the shoulder.