MRI without contrast is an unreliable method for detection of capsular reaction following shoulder surgery
2012 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455Article in journal (Refereed) Submitted
Subacromial decompression is a common surgical procedure in patients with subacromial outlet impingement. The results are often good, although some patients develop adhesive capsulitis with postoperative pain and stiffness. The main aim of the present study was to analyze the reaction of the joint capsule 3 months after subacromial decompression using MRI without contrast. We also wanted to study if there was a relation between the capsular reaction and the Constant score (CS) or the subjective shoulder value (SSV).
Forty-eight patients with a median age of fifty-six years underwent subacromial decompression with or without AC-joint resection. They were investigated with a standard x ray and MRI pre surgery and MRI three months after surgery. The CS and SSV were measured preoperatively and at three months, six months, and two years postoperatively for SSV. Two musculoskeletal radiologists independently evaluated the MRI images and used a scoring system from 0-7.
The relationship between the baseline CS and the MRI pre-surgery score was significant for both raters. There were a significant difference between the raters’ pre and post-surgery average MRI scores, which simply means that there was a difference found in the average score between baseline and three months. However, the inter-rater reliability was poor. The improvement in the CS from baseline to three and six months postoperation was significant. The subjective shoulder value improved at three, six and 24 months after surgery.
MRI is an unreliable method to study capsular reaction in the shoulder joint due to the high subjectivity of the radiologists. Considerable improvements were observed in the CS and the SSV.
Place, publisher, year, edition, pages
IdentifiersURN: urn:nbn:se:uu:diva-167686OAI: oai:DiVA.org:uu-167686DiVA: diva2:492300