title: Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture.
abstract: OBJECTIVE
  The aim of this retrospective study was to measure the inferior glenohumeral capsule thickness of shoulders clinically affected by capsular contracture by comparison to the contralateral asymptomatic side.
  
  
  METHODS
  Bilateral shoulder ultrasound (US) examinations of 20 patients with clinically or MRI proven unilateral capsular contracture were retrospectively assessed. Inferior capsule evaluation was performed with a transducer placed within the axilla in maximally abducted shoulders. Measurements were symmetrically performed orthogonally to the inferior glenohumeral ligament (IGHL) in the axial plane; the coronal plane was used to ensure the tension of the IGHL. The significance of any difference in thickening was assessed with the Mann-Whitney test.
  
  
  RESULTS
  The average thickness was 4.0 mm in shoulders with capsular contracture vs. 1.3 mm in asymptomatic contralateral shoulders (P < 0.0001). Twenty per cent of patients with capsular contracture and inferior capsule thickness increase showed US features of other painful diseases of the rotator cuff.
  
  
  CONCLUSIONS
  The thickness of the inferior capsule is measurable through ultrasound examination and appears to be increased in shoulders with capsular contracture. Exploration of the inferior aspect of the shoulder joint could be added to shoulder US examination protocols for capsular contracture assessment even if other rotator cuff abnormalities are diagnosed by US.
  
  
  CONCLUSIONS
  • Ultrasound is increasingly used to diagnose shoulder problems. • The thickness of the inferior glenohumeral ligament is measurable in the axilla. • The inferior glenohumeral ligament appears thickened in shoulders with capsular contracture. • Capsular contracture ultrasound features can be associated with other rotator cuff problems.
authors: Department of Radiology, University Hospital of Rouen, 1, Rue de Germont, 76031, Rouen Cedex, France, paul.michelin@chu-rouen.fr.
authors: Paul
authors: P
authors: Michelin
authors: Yohann
authors: Y
authors: Delarue
authors: Fabrice
authors: F
authors: Duparc
authors: Jean Nicolas
authors: JN
authors: Dacher
mesh_terms: D000328:Adult; D000368:Aged; D003286:Contracture / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D017006:Rotator Cuff / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*
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