It is possible that a frozen shoulder (adhesive capsulitis) can show up on your MRI.
The most common findings with symptomatic suspected frozen shoulder are a thickening of the inferior glenohumeral ligament and coracohumeral ligament thickening.
Other findings include the following as described in this study. I’ve bolded the different structures and areas that this study found were indicated.
Also, please keep in mind that this is a systematic review that looked at many studies. Additionally, the sensitivity and specificity were only 80%, meaning that there is a fairly large margin of error here, too.
“Results: In total, 15 studies were included, and 74 overlapping descriptors were subsumed under six features. All six features were found to be informative for ACS diagnosis [coracohumeral ligament thickening: DOR, 13; 95% CI, 6-29; fat obliteration of the rotator interval (RI): DOR, 8; 95% CI, 3-24; RI enhancement: DOR, 44; 95% CI, 14-141; axillary joint capsule enhancement: DOR, 52; 95% CI, 27-98; inferior glenohumeral ligament (IGHL) hyperintensity: DOR, 31; 95% CI, 8-115; IGHL thickening: DOR, 28; 95% CI, 11-70]. The sensitivity and specificity of enhancement of the RI and axillary joint capsule and IGHL hyperintensity were > 80%.”
https://pubmed.ncbi.nlm.nih.gov/29978436/
Will an X-ray show frozen shoulder changes?
An x-ray will not show frozen shoulder changes.
The reason for this is that an x-ray primarily shows bone. It does not give a good picture of soft tissue which is what adhesive capsulitis often affects.
What should I do if my MRI shows a frozen shoulder?
Our best available evidence suggests that early and often physical therapy in addition to a corticosteroid injection seems to be the best path forward when treating a frozen shoulder.
If you’re curious about the fastest way to heal frozen shoulder you’ll want to read this article I wrote.
How Important Is It For Me To Get An MRI to Diagnose Frozen Shoulder?
Getting an MRI for a suspected frozen shoulder may speed up and confirm the need to receive a corticosteroid injection, so, in this instance, it could be beneficial.
But, in many cases, the diagnosis of a frozen shoulder during the physical exam and treatment can be enough to determine what steps may be needed to help heal.
For example, if I have a patient who comes in and they can only lift their arm like this and it’s been progressively worse over the course of several weeks or months, and they have a lack of passive range of motion as well, I can be pretty confident that this may be frozen shoulder.
I can be even more sure of that diagnosis if it doesn’t respond to treatment dramatically over the next couple of weeks.
Overall, an MRI is not necessary however it could be helpful to determine if you need an injection or not. This may or may not help with symptoms as the data I have reviewed can be somewhat equivocal.
I wrote another article about injections and frozen shoulder that you can check out with that link.
Key Takeaways
- While an MRI may be helpful to diagnose a true frozen shoulder, it is likely not necessary and won’t change the outcome
- Getting an MRI may increase the odds that you receive an injection. However, be advised that even without imaging your physician and physical therapist may recommend this.
- There are several tissue changes at the shoulder that occur with adhesive capsulitis, but, this is not a 100% certainty. Specificity and sensitivity are only at 80%.
