Ultrasonographic Findings in Periarthritis of the Shoulder and Their Correlation With Clinical Severity

Periarthritis (PA) of the shoulder is a common cause of pain and disability. Although MRI is the standard imaging modality, ultrasonography (USG) is a cost-effective and accessible alternative. However, evidence correlating USG findings with clinical severity in Indian settings remains limited. This study evaluated the ultrasonographic findings in PA of the shoulders and determined their correlation with clinical parameters, including pain, disability, and passive range of motion (PROM).

This cross-sectional study included 79 patients with unilateral PA of the shoulder at a tertiary care academic institute in India. Pain was assessed using the Visual Analogue Scale (VAS), disability using the Shoulder Pain and Disability Index (SPADI), and PROM using a universal goniometer. Bilateral shoulder USG was performed to measure coracohumeral ligament (CHL) thickness, rotator interval (RI) thickness, axillary recess (AR) thickness, and long head of biceps tendon (LHBT) effusion. Statistical analysis included t-tests and correlation coefficients.

USG parameters were significantly higher on the affected side compared to the unaffected side: CHL (2.73 ± 0.66 vs 2.09 ± 0.63 mm), RI (1.72 ± 0.53 vs 1.39 ± 0.35 mm), AR (3.85 ± 1.57 vs 2.30 ± 1.09 mm), and LHBT effusion ((1.40 (0.00-3.00) vs 0.00 (0.00-1.00) mm) (p < 0.001). PROM was significantly restricted in all movements. No significant correlation was observed between USG parameters and VAS or SPADI scores. However, AR thickness showed a fair positive correlation with PROM restriction (p < 0.05).

USG reliably detects structural changes in patients with shoulder pain and limited PROM in one clinically relevant plane. AR thickness correlates with functional limitation and may serve as a useful imaging marker.