Bloodpool SPECT/CT offers enhanced sensitivity for the diagnosis of frozen shoulder

Adhesive capsulitis (frozen shoulder) is a common condition characterized by pain and progressive restriction of shoulder mobility, often requiring imaging for differential diagnosis. While bone scintigraphy is occasionally performed, the diagnostic potential of bloodpool SPECT/CT has never been evaluated.

We retrospectively analyzed 18 affected shoulders in 17 patients who underwent standardized bone scintigraphy with both bloodpool and late-phase SPECT/CT. Uptake was visually assessed in four predefined capsular regions.

Bloodpool SPECT/CT revealed increased uptake in the rotator cuff interval in 100% of pathological shoulders, followed by the axillary recess (72%), anterior joint capsule (67%), and posterior joint capsule (44%). Late-phase diffuse uptake was present in 78% of cases. In three pathological shoulders, uptake in the rotator cuff interval was the only abnormality at the bloodpool phase.

This study suggests that increased uptake in the rotator cuff interval on bloodpool SPECT/CT may be associated with adhesive capsulitis and could represent a sensitive imaging pattern. Further prospective studies are required to determine the diagnostic value of blood-pool SPECT/CT in patients with shoulder pain.