title: Elasticity of the Coracohumeral Ligament in Patients with Adhesive Capsulitis of the Shoulder.
abstract: OBJECTIVE
  To evaluate the elasticity of the coracohumeral ligament (CHL) in healthy individuals and patients with clinical findings suggestive of unilaterally involved adhesive capsulitis of the shoulder (ACS).
  
  
  METHODS
  The institutional review board approved this single-institution prospective study, which was performed between November 15, 2012, and July 8, 2014. Informed consent was obtained from all subjects. Measurement of CHL thickness was performed in the axial oblique plane under shoulder maximal external rotation. Shear-wave elastography (SWE) was used to evaluate elasticity of the CHL in healthy individuals (11 men, 19 women aged 22-62 years) and those with clinical findings suggestive of ACS (nine men, 11 women aged 41-70 years). SWE was performed in the shoulder-neutral position and under maximal external rotation. The Wilcoxon signed-rank test was performed to compare the thickness and elastic modulus of the CHL between bilateral shoulders.
  
  
  RESULTS
  In all subjects, the CHL elastic modulus was larger under maximal external rotation than in the neutral position (P < .001 for all). For healthy subjects, there was no significant difference in the CHL elastic modulus between the dominant and nondominant shoulders. For patients presumed to have ACS, the CHL thickness was significantly greater in the symptomatic shoulder than in the unaffected shoulder (P < .001). The CHL elastic modulus of the symptomatic shoulder (median, 234.8 kPa; interquartile range [IQR], 174.4-256.7 kPa) was significantly greater than that of the unaffected shoulder (median, 203.3 kPa; IQR, 144.1-242.7 kPa) in the shoulder-neutral position (P = .004) but not under maximal external rotation (P = .123). When bilateral shoulders were maintained at the same angle of external rotation, the CHL elastic modulus was greater in the symptomatic shoulder than in the unaffected shoulder (P = .005).
  
  
  CONCLUSIONS
  In patients with clinical findings suggestive of ACS, SWE showed that the CHL is stiffer in the symptomatic shoulder than in the unaffected shoulder.
authors: From the Department of Physical Medicine and Rehabilitation, National Taiwan Hospital, College of Medicine, National Taiwan University, 7 Chan-Shan South Rd, 100 Taipei, Taiwan.
authors: Chueh-Hung
authors: CH
authors: Wu
authors: From the Department of Physical Medicine and Rehabilitation, National Taiwan Hospital, College of Medicine, National Taiwan University, 7 Chan-Shan South Rd, 100 Taipei, Taiwan.
authors: Wen-Shiang
authors: WS
authors: Chen
authors: From the Department of Physical Medicine and Rehabilitation, National Taiwan Hospital, College of Medicine, National Taiwan University, 7 Chan-Shan South Rd, 100 Taipei, Taiwan.
authors: Tyng-Guey
authors: TG
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004548:Elasticity; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012399:Rotation; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography