Diagnostic value of high-frequency ultrasound combined with magnetic resonance in different clinical stages of frozen shoulder: A retrospective cohort study.

Abstract

BackgroundFrozen shoulder (FS) is a common musculoskeletal disease. Imaging plays an active role in the clinical diagnosis and staging of FS.ObjectiveThis study is undertaken to assess the application value of high-frequency ultrasound (HFU) combined with magnetic resonance (MR) in clinical staging diagnosis of FS.MethodsThis was a retrospective cohort study. The medical records of FS patients (from January 2021 to February 2022, n = 100) were collected. Patients were categorized into stage I (n = 30), stage II (n = 35) and stage III (n = 35) groups. The diagnostic value of HFU-related and MR-related indicators was assessed by the receiver operating characteristic (ROC) curve. The correlation between HFU/MR indicator and passive range of motion-related indicators was analyzed by Spearman rank method.ResultsThere were no statistically significant differences in gender, age, height, weight, and affected shoulder (left: right) among the three groups at different stages (<i>p </i>> 0.05). HFU and MR in combination had a higher diagnostic coincidence rate when compared to their single use (96.00% vs. 91.00% or 93.00%). There was high diagnostic value for inferior capsule thickness (ICT) (area under the curve (AUC) = 0.914, <i>p </i>< 0.001, 95%<i>CI</i> (0.836-0.992)), glenohumeral distance (GHD) (AUC = 0.999, <i>p </i>< 0.001, 95%<i>CI</i> (0.996-1.000)) and articular capsule thickness (ACT) (AUC = 1.000, <i>p </i>< 0.001, 95%<i>CI</i> (0.998-1.000)) in stage I FS, for ICT (AUC = 0.947, <i>p </i>< 0.001, 95%<i>CI</i> (0.885-1.000)) and GHD (AUC = 0.974, <i>p </i>< 0.001, 95%<i>CI</i> (0.949-0.999)) in stage II FS, and for ACT (AUC = 0.989, <i>p </i>< 0.001, 95%<i>CI</i> (0.975-1.000)) in stage III FS. ICT/ACT positively correlated with internal rotation (IR), and negatively correlated with external rotation (ER)/extension (EX)/flexion (FL)/abduction (AB). GHD had a negative correlation with IR, and a positive correlation with ER/EX/FL/AB.ConclusionHigh-frequency ultrasound combined with magnetic resonance can improve the accuracy in clinical diagnosis of FS, promote better staging of FS, and provide a more reliable basis for clinical diagnosis and treatment of FS.