0:00

So this is a patient that has

0:02

right adhesive capsulitis involving

0:05

the right glenohumeral joint.

0:08

And the patient also developed a very

0:09

severe right-sided brachial plexopathy.

0:13

So when we look at the coronal fat-

0:15

suppressed T1-weighted image, what we

0:16

see is diffuse abnormal enhancement

0:18

involving the right glenohumeral joint.

0:21

which is extending into the soft tissues.

0:24

When we look at the axial images,

0:25

what we can see here is this abnormal

0:27

enhancement extending into the

0:29

glenohumeral joint to involve the muscles.

0:32

When we go back to the left-hand

0:34

side, again, what we have to do is

0:36

always find that brachial plexus.

0:38

So, on this image, it's very easy to find.

0:40

There's our subclavian artery.

0:42

And as we follow the subclavian

0:44

artery down, we can see the nice,

0:46

smooth cords of the brachial plexus.

0:49

So, at this level, the brachial plexus

0:51

looks like it's fine, but again, the patient

0:53

has clearly a right brachial neuropathy.

0:57

So when we look at our STIR sequences,

0:59

or some sequence that's optimized to

1:01

look at the nerve sheets, on the left

1:05

hand side, again, we can very nicely see

1:07

the components of the brachial plexus.

1:09

Here are some of the roots of the brachial plexus.

1:12

We can see some of the trunks, the

1:14

divisions, and eventually we can very

1:16

nicely see the cords of the brachial plexus.

1:18

So I want you to compare this signal on the

1:21

left-hand side, and now compare it to the right.

1:24

On the right-hand side, we can see the abnormal

1:27

signal involving the right glenohumeral

1:29

joint that's extending into the muscle.

1:31

So there's that abnormal

1:32

signal involving the muscles.

1:35

Now we can see pretty good definition

1:36

of the cords of the brachial plexus,

1:38

but notice how we get more distantly.

1:41

Notice the diffuse thickening

1:42

and abnormal signal involving the

1:44

distal cords of the brachial plexus.

1:47

As they extend along the

1:48

chest wall into the upper arm.

1:51

And again, compare the right-hand

1:53

side and compare that with the

1:55

left-hand side that we see here.

1:58

So, this clearly demonstrates abnormal signal

2:01

and thickening involving the right distal cords

2:04

of the brachial plexus, which is consistent

2:06

with neuritis associated with adhesive

2:11

capsulitis involving the right shoulder.