Ultrasound in Adhesive Capsulitis: A Narrative Exploration from Static Imaging to Contrast-Enhanced, Dynamic and...

Area of Science:

• Radiology and Imaging
• Musculoskeletal Medicine
• Orthopedics

Background:

• Adhesive capsulitis (frozen shoulder) causes significant shoulder pain and mobility loss, especially external rotation.
• Magnetic resonance imaging (MRI) is the gold standard but is costly and less accessible for routine use.
• Musculoskeletal ultrasound presents a viable, accessible alternative for diagnosis and treatment guidance.

Purpose of the Study:

• To review the current evidence on the utility of musculoskeletal ultrasound in adhesive capsulitis.
• To highlight key sonographic features and advanced ultrasound techniques for diagnosis and management.

Main Methods:

• Narrative review of existing literature on ultrasound in adhesive capsulitis.
• Inclusion of static B-mode imaging, dynamic analysis, contrast-enhanced ultrasound, and sonoelastography.
• Focus on sonographic markers like coracohumeral ligament thickening and axillary recess fibrosis.

Main Results:

• Specific sonographic features (e.g., ligament thickening, fibrosis, abnormal kinematics) correlate strongly with adhesive capsulitis.
• These features show good diagnostic performance.
• Advanced techniques (contrast-enhanced ultrasound, elastography) offer insights into capsular stiffness and vascularity, aiding disease staging and treatment response prediction.

Conclusions:

• Musculoskeletal ultrasound is a valuable tool for adhesive capsulitis assessment, offering functional insights.
• Operator expertise and standardization remain challenges, but technological advancements promise broader clinical application.
• Ultrasound is poised to become central in the comprehensive management of adhesive capsulitis.