IGHL in Axillary pouch

[Zicong Zhou]

Hi Steve,
When we are examining the axillary recess/pouch, it is the thickness of inferior glenohumeral ligament that we are measuring, not the thickness of the axillary pouch, right?

My supervisor is a radiographer as well. When I told him that the diagnostic criteria for adhesive capsulitis is >4 mm in thickness of axillary pouch. He questioned “isn’t a thicker axillary pouch a better scenario, because the would perform CT to guide hydrodilatation to expand the axillary pouch”.

I am getting a bit confused with the thickness of which here. Could you provide some insight for me, please?

Thank you,
Leo

[Stephen Bird]

Hi Leo,

Yes, it is the inferior glenohumeral ligament (IGHL) that we are measuring, not the axillary pouch.

If you like, it is the wall of the axillary pouch that you are measuring.

When the IGHL becomes thickened the axillary recess diminishes and the glenohumeral joint becomes restricted in movement.

Think of the axillary recess as being a pouch full of synovial fluid. and the IGHL being the wall of the pouch. As the IGHL thickens it reduces the space inside the pouch and the axillary recess becomes smaller.

I don’t actually measure the IGHL as it is difficult to reproduce the calliper positions reliably and there are several articles showing different techniques.

I tend to rely on a side by side comparison as adhesive capsulitis is almost never bilateral simultaneously so the comparison is the key.

Steve

[Zicong Zhou]

Hi Steve,
Thank you very much for clarification. Now it makes sense.

Kind regards,
Leo

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