Inferior Glenohumeral Capsule Thickness in Adhesive Capsulitis: An Ultrasonographic Evaluation
Sheik Mohammed Fahim, Waseem Ansari, Srikanth E Neruganti
Author(s)2Assistant Professor, Department of Orthopedics, East Point College of Medical Sciences & Research Centre, Bengaluru, Karnataka, India
3Senior Consultant, Department of Orthopedic Surgeon, Sunlife Hospital, Bengaluru, Karnataka, India
Abstract
Background: Adhesive capsulitis, another name for frozen shoulder, is characterized by increasing shoulder discomfort and mobility limitation. Structural changes in the inferior glenohumeral capsule are believed to play a significant role in the pathophysiology of this condition. Ultrasonography has emerged as a reliable imaging modality for evaluating these capsular changes. The objective is to look for an appropriate location for measuring the thickness of the inferior glenohumeral joint capsule using ultrasonography that can represent the range of motion in frozen shoulder patients. Material and Methods: This observational study included 50 participants, comprising control subjects and patients with frozen shoulder. Shoulder range of motion was assessed clinically, and ultrasonographic measurements of inferior glenohumeral capsule thickness were obtained at three anatomical sites: the surgical neck, anatomical neck, and parenchymal regions. Intrarater reliability was evaluated using intraclass correlation coefficients, and correlations between capsule thickness and range of motion were analysed using Pearson’s correlation. Results: With ICC values ranging from 0.92 to 0.96, ultrasonographic measurements showed outstanding reliability. Patients with frozen shoulder showed significantly greater capsule thickness than controls at all measurement sites (p < 0.001). A negative correlation was observed between capsule thickness and shoulder range of motion, with the strongest correlation observed in the parenchymal region. Conclusion: Inferior glenohumeral capsule thickness measured using ultrasonography is significantly associated with restricted shoulder mobility in frozen shoulder. The parenchymal measurement site appears to reflect functional limitation best and may serve as a useful parameter in the clinical evaluation of adhesive capsulitis.
Keywords: Frozen shoulder, Adhesive capsulitis, Ultrasonography, Glenohumeral capsule thickness.