Prevalence and Correlation between MRI Findings and Outcome of Conservative Treatment in Primary Idiopathic Frozen...

Area of Science:

• Orthopedics
• Radiology
• Musculoskeletal Imaging

Background:

• Frozen shoulder (FS) is a common condition characterized by shoulder pain and progressive loss of motion.
• Idiopathic frozen shoulder significantly impacts patients' quality of life due to restricted shoulder movement.
• Conservative management is the primary treatment approach for frozen shoulder, but outcomes can vary.

Purpose of the Study:

• To investigate the correlation between magnetic resonance imaging (MRI) findings and the outcomes of conservative management in patients with primary idiopathic frozen shoulder.
• To identify specific MRI features that predict treatment success or failure in frozen shoulder.

Main Methods:

• A prospective cohort study involving 65 patients with frozen shoulder.
• MRI scans were performed before initiating non-operative treatment.
• Outcomes were assessed using range of motion (ROM), Visual Analog Scale (VAS) for pain, Shoulder Stiffness Score (SST), and Oxford Shoulder Score (OSS).

Main Results:

• Anterior extracapsular edema, glenoid portion capsular thickness, and axillary recess effusion correlated significantly with treatment outcomes (pain, stiffness, and ROM).
• Increased thickness of the coracohumeral ligament (CHL) and inferior glenohumeral ligament (IGHL) showed negative correlations with improvement in external rotation, abduction, and flexion.
• Mean height of the axillary recess (HAR) negatively correlated with pain (VAS) and functional scores (OSS).

Conclusions:

• Joint capsule thickness and axillary fold effusion are key MRI indicators for predicting refractory frozen shoulder.
• MRI can be a valuable tool for managing complex or persistent frozen shoulder cases.
• These findings aid in setting realistic expectations for conservative treatment outcomes in patients with specific MRI findings.