Glenohumeral capsule thickness in teenagers

[Diane]

Hi Steve,
I was scanning this male teenager with a sore shoulder from overhead movement during cricket.
Everything was fine until I did a glenohumeral capsule measurement. The capsule that connects onto the humeral shaft/neck looks thicker than what I’m used to seeing in adults? When I compared it to the other side, it was the same so I thought it was just normal.

Is this just the normal appearance for teenagers? I’ve attached an image for reference.

Thanks!

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[Stephen Bird]

If this is a bilateral finding I am happy it is normal.

I don’y use this technique in teenagers as they are the wrong demographic to get adhesive capsulitis. If someone tried to convince me they had a teenager with adhesive capsulitis I would be sceptical.

If it was unilateral following a cricket injury I would consider a HAGL injury which is an inferior glenohumeral ligament avulsion from the humeral (an inferior GH joint capsule avulsion) but this would be unilateral and more disorganised than your case.

The other possibility is a synovitis associated with childhood RA, but this is a bit pie in the sky without a history of chronic joint problems and you would expect to see other evidence of GH joint synovitis in the LHBT sheath and the RC interval etc. It would also be rare for it to be so perfectly symmetrical.

I think the likely thing is you have seen normal.

Steve

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