Investigations
1st investigations to order
plain film radiographs
Test
Plain radiographs (anteroposterior, lateral, and axillary views of the glenohumeral joint) are the preferred initial test.[31] Abnormal findings need to be investigated further to eliminate other shoulder pathologies such as dislocations of the shoulder, particularly locked posterior dislocations.
Result
anteroposterior, scapular Y, and axillary views will usually be normal
ultrasound
Test
In certain instances where clinical examination suggests adhesive capsulitis, symptoms of impingement, or painful palpable mass, ultrasound (US) may be considered as an initial imaging study. US has the advantage of allowing provocative manoeuvres to assess impingement.[31][32][33]
Result
thickening of the coracohumeral ligament and the soft-tissue structures in the rotator cuff interval
Investigations to consider
MRI/MR arthrogram shoulder
Test
MRI/MR arthrogram is useful to demonstrate a lack of concomitant shoulder pathology such as labral or rotator cuff tears.[31][34][35]
According to the American College of Radiology (ACR) appropriateness criteria®, MRI without intravenous contrast is usually appropriate when adhesive capsulitis is suspected and initial radiographs are normal or inconclusive.[31]
MR arthrogram may be appropriate, but is not routinely recommended when evaluating for adhesive capsulitis due to conflicting results of efficacy studies.[31][36][37]
Result
decreased capsular volume and changes in rotator interval dimensions may be present; may show evidence of a thickened capsule
CT arthrogram
Test
CT arthrogram may be beneficial if the diagnosis is not clear from history, physical examination, and plain film radiographs.
CT arthrogram is not routinely recommended when evaluating for adhesive capsulitis and, according to the ACR appropriateness criteria®, is not usually appropriate.[31]
Result
decreased capsular volume may be present; may show evidence of a thickened capsule
Use of this content is subject to our disclaimer