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Frozen Shoulder: MR Arthrographic Findings¹

¹ From the Departments of Radiology (B.M., C.W.A.P., J.H., M.Z.) and Orthopedic Surgery (C.G.), Orthopedic University Clinic Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland. Received July 31, 2003; revision requested October 17; final revision received February 10, 2004; accepted March 18. Address correspondence to B.M. (e-mail: mengiardi@yahoo.de).

View larger version (40K): [in a new window]   Figure 1. Scheme of measurement. A, Thickest portion of CHL on sagittal oblique T1-weighted spin-echo images was measured perpendicular to CHL surface (arrowheads). B, Capsular thickness (small arrow) in rotator cuff interval was measured 1.5 cm anterolateral (thick dashed line) to base (thin dashed line) of coracoid process on sagittal oblique T1-weighted spin-echo images. Thickest portion of capsule (large arrows) perpendicular to surface of humeral head was measured along a radial line drawn to center of humeral head. C, Thickest portion of capsule in axillary recess was measured on coronal oblique intermediate-weighted images separately for humeral and glenoidal portions (left, double arrows). Maximal height and width of axillary recess (right, double arrows; dotted line indicates level of upper end of axillary recess) were measured on coronal oblique images, and depth was measured on corresponding transverse images (not shown).

View larger version (132K): [in a new window]   Figure 2. Sagittal oblique T1-weighted (700/12) image shows thickened CHL (arrows) in a 57-year-old patient with frozen shoulder. C = coracoid process.

View larger version (67K): [in a new window]   Figure 3a. Line drawings (top row) and corresponding sagittal oblique T1-weighted (600/12) images (bottom row) of subcoracoid fat triangle. Borders of the triangle (arrowheads) are defined anterosuperiorly by the coracoid process (C), superiorly by the CHL (arrow), and posteroinferiorly by the joint capsule. (a) Normal anatomy in a subject without frozen shoulder. (b) Partial obliteration of subcoracoid fat triangle in a 57-year-old patient with frozen shoulder. (c) Complete obliteration of subcoracoid fat triangle (ie, subcoracoid triangle sign) in a 55-year-old patient with frozen shoulder.

View larger version (67K): [in a new window]   Figure 3b. Line drawings (top row) and corresponding sagittal oblique T1-weighted (600/12) images (bottom row) of subcoracoid fat triangle. Borders of the triangle (arrowheads) are defined anterosuperiorly by the coracoid process (C), superiorly by the CHL (arrow), and posteroinferiorly by the joint capsule. (a) Normal anatomy in a subject without frozen shoulder. (b) Partial obliteration of subcoracoid fat triangle in a 57-year-old patient with frozen shoulder. (c) Complete obliteration of subcoracoid fat triangle (ie, subcoracoid triangle sign) in a 55-year-old patient with frozen shoulder.

View larger version (70K): [in a new window]   Figure 3c. Line drawings (top row) and corresponding sagittal oblique T1-weighted (600/12) images (bottom row) of subcoracoid fat triangle. Borders of the triangle (arrowheads) are defined anterosuperiorly by the coracoid process (C), superiorly by the CHL (arrow), and posteroinferiorly by the joint capsule. (a) Normal anatomy in a subject without frozen shoulder. (b) Partial obliteration of subcoracoid fat triangle in a 57-year-old patient with frozen shoulder. (c) Complete obliteration of subcoracoid fat triangle (ie, subcoracoid triangle sign) in a 55-year-old patient with frozen shoulder.

View larger version (147K): [in a new window]   Figure 4. Sagittal oblique T1-weighted (700/12) image shows synovitis-like abnormality (arrowheads) with blurred borders and intermediate signal intensity at superior border of subscapularis tendon in a 55-year-old patient with frozen shoulder.