Apropos Atul’s case, I believe this case precedes any biopsy proof or treatment for his suspected prostate cancer.The prostate MRI was only 1-2 weeks ago….and the findings were incidental on the prostate MRI.
The subsequent bilateral hip MRI adds nothing and appears no different.
From Atul:
I believe the differential between PMR and Adhesive Capsulitis will mostly be related to the clinical course, since labs and imaging have a lot of overlap.
Found this paper from Brazilian colleagues – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9743254/
"One major differential diagnosis of pericapsular soft tissue edema of the shoulder is adhesive capsulitis, a well known condition that involves the axillary recess and the rotator interval of the shoulder(21). The differentiation between PMR and adhesive capsulitis relies not only on clinical and biochemical data but also on imaging findings. Periarticular inflammatory involvement is usually more extensive in PMR, involving the tendon and muscle bellies, than in adhesive capsulitis(7). However, if the relevant clinical data are unavailable, this differential diagnosis can be challenging."
Definitely a topic that needs more data to be understood. Last year I posted here in OCAD a similar case, that brought interesting discussion as well.
Best,
Atul\
Prostate MRI revealed a lesion in the transitional zone reported as PI-RADS 4, likely prostate cancer
Incidental finding in both hip joints
MRI of both hips were also done to evaluate hip arthrosis, the joint spaces are preserved, there is no hip effusion/synovitis or erosions (the changes are better demonstrated in the prostate MRI…so hip MRI not shown).
There is bilateral capsular thickening, edema and pericapsular edema.
I have seen adhesive capsulitis in the hips, but never so flagrant nor synchronous / bilateral….should anything else be considered in the differential diagnosis?Thanks.
Hilary
