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Magnetic resonance arthrographic findings of presumed stage-2 adhesive capsulitis: focus on combined rotator cuff pathology.

Orthopedics 2009 January
The purpose of this study was to report the magnetic resonance arthrography (MRA) findings of patients considered to have stage-2 idiopathic adhesive capsulitis and to identify differences in rotator cuff pathologies between 2 age groups (ie, =or< and >60 years). Eighty-one patients, considered to have stage-2 idiopathic adhesive capsulitis based on medical history and a physical examination underwent MRA. Magnetic resonance evaluations focused on combined pathologies other than adhesive capsulitis, especially on the supraspinatus tendon. The pathologies of supraspinatus tendon were divided into 4 categories: normal, tendinosis, partial-tears, and full-thickness tears. Mean patient age was 66 years and mean symptom duration was 8.9 months. There were 38 men and 43 women. Overall, 50 patients (61.7%) showed some form of supraspinatus tendon pathology [small full-thickness tears 6 (7.4%), partial-thickness tears 25 (30.9%), and supraspinatus tendon tendinosis 19 (23.5%)]. The most common MRA finding, other than rotator cuff pathology, was the impression of adhesive capsulitis in 58 patients (71.6%). Group 2 (>60 years) showed a higher prevalence of full and partial-thickness tears (P<.05), however the overall prevalence of supraspinatus tendon pathologies were similar in those younger than and older than 60 years (P=.1795). Approximately 1/3 of stage-2 adhesive capsulitis patients showed some form of supraspinatus tendon tear by MRA, and <10% of patients who were considered to have idiopathic adhesive capsulitis had a full-thickness tear. Adhesive capsulitis patients older than 60 years appeared to be more likely to have a supraspinatus tendon tear.

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