title: Characteristics of dynamic magnetic resonance imaging of idiopathic severe frozen shoulder.
abstract: BACKGROUND
  The purpose of this study was to evaluate the effectiveness of current techniques for dynamic 3-dimensional magnetic resonance imaging (MRI) in the diagnosis of idiopathic severe frozen shoulder (FS).
  
  
  METHODS
  Subjects consisted of 5 healthy volunteers and 16 patients with idiopathic severe FS. We defined severe idiopathic FS as follows: range of motion ≤100° in forward flexion, ≤10° in external rotation, and ≤L5 in internal rotation. All patients suffered from continued global range of motion loss for at least 6 months. We evaluated the diagnostic characteristics of 3-dimensional dynamic MRI in FS patients compared with those in healthy volunteers.
  
  
  RESULTS
  MRI of all FS patients displayed an abnormal intake of blood flow from the acromial arterial network and the branches of circumflex humeral arteries into the axillary pouch and the rotator interval. We named this finding "burning sign." The burning sign was present at all phases of the condition. In the FS group, the patients with enhanced deposition of contrast medium in the axillary pouch in the delayed phase (n = 11) had a statistically significant score for pain during exercise, higher than that of patients with reduced deposition of contrast medium at the same site (n = 5; P = .027).
  
  
  CONCLUSIONS
  Burning sign is an abnormal finding that appears in dynamic MRI of severe FS. Hence, the burning sign may be associated with pain and inflammation in idiopathic FS.
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan. Electronic address: sasakou@jichi.ac.jp.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sasanuma
authors.affiliation: Department of Radiology, Jichi Medical University, Tochigi, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Sugimoto
authors.affiliation: Department of Radiology, Jichi Medical University, Tochigi, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Fujita
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanaya
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Iijima
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
mesh_terms: D000328:Adult; D000368:Aged; D002062:Bursitis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012039:Regional Blood Flow; D012785:Shoulder Joint / Q000098:blood supply / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Frozen shoulder; abnormal vessel; burning sign; dynamic MRI; healthy volunteer; pain