Annals of Rehabilitation Medicine

Original Article: J Korean Acad Rehabil Med. 2007;31(6):735-741.; Clinical Efficacy of Quantitative Bone Scintigraphy in Shoulder Adhesive Capsulitis.; Lee, Yong Taek , Park, Jung Mi , Chung, Seung Hyun; ¹Department of Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea.
²Department of Nuclear Medicine, Bucheon Hospital, Soonchunhyang University College of Medicine, Korea. jmipark@schbc.ac.kr
³Department of Rehabilitation Medicine, National Cancer Center, Korea.

Abstract: Objective
To evaluate the clinical efficacy of the quantitative bone scintigraphy in shoulder adhesive capsulitis (AC). Method: Twenty-six AC patients and age-matched 18 healthy controls underwent bone scintigraphy. For the quantitative analysis, region of interest (ROI) was drawn over each gleno-humeral joint area, excluding coracoid process, acromion and acromio-clavicular joint. We obtained the uptake ratios of affected side to unaffected side from anterior and posterior image respectively. Additionally, mean uptake ratios were calculated from both anterior and posterior ROI count. Reference values for each uptake ratio were obtained from 18 healthy controls. Clinical stages of the patients were determined according to the history and physical examination including range of motion under sonographically guided intra-articular anesthesia (Hannafin's stage). Quantitative measurements were analyzed according to Hannafin's stage and clinical findings. Results: Uptake ratios for the patients were significantly higher than the controls (p＜0.05). Sensitivities of the anterior image and mean uptake ratio were 81 % and 62% respectively. All 7 patients with abnormal findings in posterior image were stage II. Ninety-four percent in stage I and II showed abnormal mean uptake ratio. Nocturnal pain was associated with increased uptake ratio, particularly mean uptake ratio (p＜0.05).Conclusion: The findings of quantitative bone scintigraphy correlated with the clinical diagnosis, nocturnal pain and Hannafin's stage. Thus, the quantitative bone scintigraphy may be helpful in the diagnosis of shoulder AC. Additionally, mean uptake ratio and posterior image may contribute to clinical staging of AC (i.e. stage I, II and stage II respectively). (J Korean Acad Rehab Med 2007; 31: 735-741)

Keywords :Adhesive capsulitis, Bone scintigraphy, Quantitative, Sonography, Intra-articular anesthesia