Materiały źródłowe

• #1 Frozen shoulder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1315655/

  Frozen shoulder is a painful, often prolonged, condition that requires careful clinical diagnosis and management. […] In this article we consider how to diagnose frozen shoulder and how to distinguish it from other painful shoulder conditions. […] True frozen shoulder is a clinical diagnosis. […] The three hallmarks of frozen shoulder are insidious shoulder stiffness; severe pain, even at night; and near complete loss of passive and active external rotation of the shoulder. […] Lab tests are normal. […] Frozen shoulder is rare under the age of 40; the peak age is 56. […] Frozen shoulder progresses through three clinical phases. […] It lasts about 30 months, but recovery can be accelerated by simple measures. […] Nearly all patients recover, but normal range of movement may never return.

• #1 Adhesive Capsulitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0301/p297.html

  Adhesive capsulitis, also known as frozen shoulder, is a common shoulder condition characterized by pain and decreased range of motion, especially in external rotation. […] Although imaging is not necessary to make the diagnosis, a finding of coracohumeral ligament thickening on noncontrast magnetic resonance imaging yields high specificity for adhesive capsulitis. […] A 2017 study concluded that adhesive capsulitis can be accurately and consistently diagnosed with noncontrast magnetic resonance imaging (MRI) of the shoulder in conjunction with appropriate clinical criteria. […] MRI findings of coracohumeral ligament thickening, rotator interval infiltration of the subcoracoid fat, and axillary recess thickening yield high specificity for adhesive capsulitis. […] However, the diagnosis of adhesive capsulitis is a clinical diagnosis and the use of MRI should be reserved for the evaluation of other sources of shoulder pathology, not to confirm a diagnosis of adhesive capsulitis.

• #1 Frozen shoulder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/diagnosis-treatment/drc-20372690

  During the physical exam, a health care provider might ask you to move your arm in certain ways. This is to check for pain and see how far you can move your arm (active range of motion). Then you might be asked to relax your muscles while the provider moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion. […] Frozen shoulder can usually be diagnosed from signs and symptoms alone. But imaging tests such as X-rays, ultrasound or MRI can rule out other problems.

• #1 Frozen Shoulder – Adhesive Capsulitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/frozen-shoulder

  Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. […] After discussing your symptoms and medical history, your doctor will examine your shoulder. Your doctor will move your shoulder carefully in all directions to see if movement is limited and if pain occurs with the motion. The range of motion when someone else moves your shoulder is called „passive range of motion.” Your doctor will compare this to the range of motion you display when you move your shoulder on your own („active range of motion”). People with frozen shoulder have limited range of motion both actively and passively. […] Other tests that may help your doctor rule out other causes of stiffness and pain include: X-rays. Dense structures, such as bone, show up clearly on X-rays. In addition, X-rays may show other problems in your shoulder, such as arthritis. Magnetic resonance imaging (MRI) and ultrasound. These imaging tests can create better images of soft tissues than X-rays. They are not required to diagnose frozen shoulder; however, they may help to identify other soft tissue injuries in your shoulder, such as a rotator cuff tear.

• #1 Frozen Shoulder Diagnosis | How to assess Frozen Shoulder

  https://www.physiotutors.com/wiki/frozen-shoulder-diagnosis/

  Frozen shoulder has a prevalence of 2%-5.3% in the general population with a peak at 55 years of age and a higher prevalence amongst women patients with diabetes and thyroid dysfunction and a previous episode of Frozen shoulder on the contralateral side. […] The stiff and painful shoulder is identified by a significant and equal loss of both active and passive shoulder movements but has minimal pain on resisted testing. […] To diagnose Frozen shoulder in your physical examination the first examine external rotation in the zero position and compare it to the other side. […] An external rotation loss of at least 50% compared to the other side or less than 30 is considered a positive finding. […] According to a study done by Holman et al. (2015), all patients suspected of frozen shoulder displayed some degree of active muscle guarding. […] For this reason, it might be helpful to perform the coracoid pain test to distinguish between a true and a pseudo frozen shoulder. […] Another orthopedic test for Frozen Shoulder is the Shoulder Shrug Sign.

• #1 Patient education: Frozen shoulder (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

  Frozen shoulder is a condition that causes shoulder pain and limits the shoulder’s range of motion. […] If you have symptoms of frozen shoulder, your health care provider will examine you to learn what movements elicit symptoms and how limited your mobility is. […] In most cases, health care providers can tell when a person has frozen shoulder based on the results of the physical exam. […] Injection test — An injection test can help determine whether a person has frozen shoulder or another shoulder condition. […] People with suspected frozen shoulder very rarely need imaging tests such as x-rays, magnetic resonance images (MRIs), or ultrasounds. […] Experienced doctors can usually diagnose frozen shoulder based on the symptoms it causes and how it limits movement.

• #1 Idiopathic frozen shoulder

  https://www1.racgp.org.au/ajgp/2019/november/idiopathic-frozen-shoulder

  Confirming that external rotation is not possible with both active and passive movement is important in making the diagnosis. […] A key element in making the correct diagnosis is being able to differentiate limitation of shoulder movement secondary to pain, which is very common in most musculoskeletal conditions, versus limitation secondary to actual physical or mechanical restrictions. […] The pathognomonic sign of frozen shoulder is almost complete loss of active and passive external rotation. […] It is essential to be able to differentiate between limited range of movement secondary to a mechanical block due to glenohumeral capsular tightness and restriction, and limitation secondary to pain. […] Intra-articular corticosteroid injections are safe and effective and have been shown to hasten improvement in pain and function.

• #1 Frozen shoulder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1315655/

  There are few specific laboratory tests or radiological markers for frozen shoulder, and the diagnosis is essentially clinical. […] Most orthopaedic surgeons would not investigate a frozen shoulder beyond a plain x ray. […] When plain radiographs of the frozen shoulder are taken they may well be reported as normal, although they may show periarticular osteopenia as a result of disuse. […] The aetiology of frozen shoulder remains unclear. […] The disease process particularly affects the anterosuperior joint capsule and the coracohumeral ligament. […] The diagnosis is essentially clinical.

• #1 Frozen Shoulder: Symptoms, Causes, Diagnosis, and Treatment | IntechOpen

  https://www.intechopen.com/chapters/80359

  Frozen shoulder is characterized by an insidious and progressive loss of active and passive mobility in the glenohumeral joint presumably due to capsular contracture. […] Primary frozen shoulder is essentially a clinical diagnosis. Frozen shoulder is characterized by an insidious and progressive loss of active and passive mobility in the glenohumeral joint presumably due to capsular contracture. Patients typically demonstrate a characteristic history, clinical presentation, and recovery. Clinical syndromes include pain, a limited range of motion (ROM), and muscle weakness from disuse. […] Imaging studies are not necessary for the diagnosis of adhesive shoulder capsulitis but may be helpful to rule out other causes of a painful and stiff shoulder. […] Radiographic examination is carried out to make the differential diagnosis and exclude other pathologies, for example, calcific tendinitis, rupture of the rotator cuff, arthritis of the glenohumeral, and acromioclavicular joint or a neoplastic process.

• #1 Adhesive Capsulitis (Frozen Shoulder): Practice Essentials, Problem, Epidemiology

  https://emedicine.medscape.com/article/1261598-overview

  Adhesive capsulitis and frozen shoulder syndrome (FSS) are two terms that have been used to describe a painful and stiff shoulder. The current consensus definition of a frozen shoulder by the American Shoulder and Elbow Surgeons is „a condition of uncertain etiology characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.” The American Academy of Orthopaedic Surgeons defines this condition as: „A condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings other than osteopenia are absent.” […] The loss of passive range of motion (ROM) is a critical element in establishing the diagnosis of a true frozen shoulder.

• #1 Adhesive Capsulitis (Frozen Shoulder) Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/1261598-workup

  Frozen shoulder syndrome (FSS) is a clinical diagnosis. Laboratory and imaging studies can be used to rule out other conditions and to confirm the likelihood of the correct diagnosis. Accurate diagnosis is essential because the treatment for FSS differs from the treatment for other shoulder entities. […] Imaging studies are not indicated in the diagnosis of FSS. No imaging modality has been definitively shown to provide greater diagnostic value, due to the heterogeneity of techniques used, and the presence of potential confounding factors limits definitive conclusions from imaging study findings. However, more recent studies are moving toward defining the criteria for imaging studies to aid in the staging of FSS. […] MRI is not initially indicated in cases of FSS. However, if the patient does not improve after a period of time (6 weeks to 3 months), then MRI is appropriate to rule out a possible rotator cuff tear or intra-articular pathology.

• #1 Frozen Shoulder Test — Objective Exam And DDx

  https://www.physio-network.com/blog/frozen-shoulder-instalment-2-objective-examination-and-ddx/

  No blood tests to confirm the presence of FS is available, however may assist in developing a causal relationship between diabetes or hypothyroidism. […] In relation to imaging, radiographs are typically normal and can help to exclude osteoarthritis, locked dislocation or sinister pathology as a cause of pain. […] Yoon et al 2017 argued that MRI can identify characteristic patho-anatomical features associated with FS, such as greater thickening and enhancement of the capsule and axillary recess and greater thickening of the soft tissue of the rotator interval. However, it was deemed the MRI findings were not relevant or able to predict prognosis or severity of symptoms. Therefore, whilst MRI may be helpful in identifying consistent patho-anatomical structures, it is not necessary in the diagnosis of FS.

• #1 Adhesive Capsulitis (Frozen Shoulder) Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/1261598-workup

  A 2018 systematic review and meta-analysis identified six features on non-arthrogram MRI that may be used to diagnose FSS, as follows: Coracohumeral ligament thickening (diagnostic odds ratio [DOR] 13), Fat obliteration of the rotator interval (DOR 8), Rotator interval enhancement (DOR 44; sensitivity and specificity 80%), Axillary joint capsule enhancement (DOR 52; sensitivity and specificity 80%), Inferior glenohumeral ligament hyperintensity (DOR 31), Inferior glenohumeral ligament thickening (DOR 28). […] Zappia et al hypothesize that the high pericapsular signal intensity corresponds to hypervascular synovitis during the frozen phase of FSS.

• #1 Frozen Shoulder: Symptoms, Causes, Diagnosis, and Treatment | IntechOpen

  https://www.intechopen.com/chapters/80359

  In patients with frozen shoulder radiographic examination is normal, however, osteopenia of the humerus head may be an indirect sign. […] Ultrasound is an essential tool for diagnosing shoulder disorders. However, the role of ultrasound in assessing and diagnosing adhesive capsulitis has not been fully studied. […] Several studies have shown that the CHL is thickened and stiffened in adhesive capsulitis on ultrasound. […] Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) may reveal thickening of capsular and pericapsular tissues as well as a contracted glenohumeral joint space. […] Arthrography is rarely indicated in the diagnosis of frozen shoulder syndrome.

• #1 Role of Ultrasonography in Diagnosis and Treatment of Frozen Shoulder

  https://www.jrd.or.kr/journal/view.html?doi=10.4078/jrd.2019.26.3.149

  Ultrasonography measurement of coracohumeral ligament thickness. Longitudinal ultrasonography scan shows that the coracohumeral ligament thickness of the affected shoulder is thicker than that of the unaffected shoulder in the patient with frozen stage frozen shoulder. […] Ultrasonography measurement of axillary recess thickness. Longitudinal ultrasonography scan shows that the axillary recess thickness of the affected shoulder is thicker than that of the unaffected shoulder in the patient with frozen stage frozen shoulder. Axillary recess ratio is 2.34 (6.14/2.62 mm). […] Glenohumeral distension arthrography under ultrasonography guidance. Capsular distension of posterior glenohumeral joint (arrow) is noted during and after distension arthrography.

• #1 Diagnosing Frozen Shoulder | NYU Langone Health

  https://nyulangone.org/conditions/frozen-shoulder/diagnosis

  NYU Langone doctors are experts in diagnosing frozen shoulder, also called adhesive capsulitis. […] To diagnose frozen shoulder, your NYU Langone doctor asks about your symptoms and determines if you have any health conditions that may put you at risk. He or she also performs the following tests. […] Your doctor evaluates range of motion as you move your arm and shoulder and then as he or she moves your arm for you. Most people with frozen shoulder have difficulty extending the arm upward, away from the body, and lowering it again. […] Sometimes, an X-ray is used to rule out other conditions that can affect the shoulder, such as bursitis. […] Your doctor may use ultrasound to look for tears in the rotator cuff, a group of muscles and tendons that connect the humerus to the shoulder blade. […] An MRI scan uses a powerful magnetic field and radio waves to create images of soft tissues inside the body. It can detect rotator cuff tears and determine if a tear is partial or complete.

• #1 Frozen Shoulder Diagnosis

  https://aidmyfrozenshoulder.com/adhesive-capsulitis/adhesive-capsulitis-diagnosis.php

  MRIs or CT scans will provide more detailed information and will help to evaluate soft tissue (muscle, tendons, ligaments, connective tissue) injuries such as fluid in the shoulder, tendonitis and/or tears. […] Arthrogram contrasts are special x-rays that show details of the shoulder capsule, such as a decrease in size (in a normal shoulder the capsule is rounded, but in a frozen shoulder the capsule is squat, square and contracted). […] Blood testing can be done if the doctor suspects the primary reason for your frozen shoulder is a result of a systemic disorder.

• #1 The frozen shoulder. Diagnosis and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/3652593/

  The differentiation between the stiff and painful shoulder without any joint capsule involvement and with capsule involvement (true adhesive capsulitis) must be established before a rational treatment can be prescribed. Arthrography establishes the correct diagnosis of adhesive capsulitis. […] Arthroscopy is not useful for either diagnosis or treatment of adhesive capsulitis but may be useful for recognition of the four stages of the disease.

• #1 Do you have a Frozen Shoulder?

  https://puresportsmed.com/blog/posts/do-you-have-a-frozen-shoulder

  A commonly self-diagnosed condition, the Frozen Shoulder continues to catch people out with only 17% of suspected Frozen Shoulders actually being diagnosed after seeing a healthcare professional. […] Unfortunately, we often find patients coming through our door that have either self-diagnosed or been told that their painful and/or stiff shoulder is the blanket diagnosis of frozen shoulder. […] It is important that stiffness is not confused by pain limiting motion. There should be a true block to range of motion passively particularly with external rotation, but often abduction and internal rotation are significantly limited too. […] The frozen shoulder sufferer will often have a rather innocuous onset with no particular mechanism of injury. […] These all raise suspicion but the previously mentioned key diagnostic criteria will change our hypothesis to a definite clinical diagnosis.

• #1 Frozen Shoulder: Causes, Symptoms, and Treatment

  https://patient.info/bones-joints-muscles/frozen-shoulder-leaflet

  How is a frozen shoulder diagnosed? The diagnosis of frozen shoulder is usually made by examination. It is rare to need an X-ray or an MRI scan of your shoulder joint. Occasionally, an ultrasound scan might be used to assess the shoulder joint. […] It is important to diagnose frozen shoulder correctly from the start, as the treatment options are different for different shoulder conditions. Other conditions that mimic frozen shoulder are:

• #1 Frozen Shoulder vs Impingement – Marietta and Atlanta, Georgia

  https://www.gahand.org/services/frozen-shoulder-vs-impingement

  To properly diagnose shoulder impingement, your physician will review your medical history and symptoms. A full assessment of your mobility and an examination of what movements increase your pain level will be made. […] Similar to diagnosing a shoulder impingement, your physician will need to review your medical history and symptoms to make a proper diagnosis of a frozen shoulder. Your range of motion will also be tested. […] An MRI is often needed to confirm the diagnosis by revealing clear imaging showing significant joint capsule thickening.

• #1 Frozen Shoulder Test — Objective Exam And DDx

  https://www.physio-network.com/blog/frozen-shoulder-instalment-2-objective-examination-and-ddx/

  Frozen shoulder IS a clinical diagnosis, so it is vital you are able to distinguish between a painful shoulder of rotator cuff (etc.) origin and a painful shoulder that is being driven by the complex pathophysiology of frozen shoulder. Correct and timely diagnosis, therefore, leads to timely and accurate intervention. […] As there is no definitive gold standard test to diagnose FS the clinical examination becomes an integral component of the battery of diagnostic tests available. […] Zuckerman and Rokito 2011 state FS is a condition characterized by functional restriction of both active and passive shoulder motion for which radiographs of the glenohumeral joint are unremarkable except for humeral head osteopenia and possible calcific tendinopathy. […] There is NO gold standard test for the diagnosis of FS. Bunker 2009 describes a simple diagnostic criterion for FS; an equal restriction of active and passive glenohumeral external rotation and an essentially normal shoulder radiograph.

• #1 Diagnosis of the Frozen Shoulder | UW Orthopaedic Surgery and Sports Medicine

  https://orthop.washington.edu/patient-care/articles/shoulder/diagnosis-of-the-frozen-shoulder.html

  The necessary and sufficient criteria for the diagnosis of a frozen shoulder are: […] A. History […] Functionally significant restriction of shoulder motion […] Absence of history of previous major shoulder injury or surgery […] B. Physical examination […] Limited glenohumeral motion in all directions […] C. Radiographs […] No changes in cartilaginous joint space […] Absence of pathological changes other than osteopenia.

• #1 Adhesive capsulitis of the shoulder | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/adhesive-capsulitis-of-the-shoulder?lang=us

  Adhesive capsulitis is principally a clinical diagnosis with no definitive diagnostic criteria. Diagnostic criteria used in some research papers (c. 2023) include the presence of at least 4 of the 5 following criteria […] in patients without prior shoulder surgery, trauma, synovitis, rotator cuff or labral injury, calcific tendinosis, or rheumatoid or septic arthritis. There are no highly sensitive nor specific clinical examination tests for adhesive capsulitis. MRI is often used to confirm the clinical diagnosis of adhesive capsulitis and exclude other shoulder conditions. The signs of adhesive capsulitis are variable with some but rarely all of the following expected to be present: […] contrast-enhancement of the inferior glenohumeral ligament and rotator interval has been shown to have a sensitivity and specificity of 90% for frozen shoulder, however, contrast administration does not significantly increase the diagnostic performance over non-contrast 3 T MRI.

• #1 Adhesive capsulitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1043

  Other diagnostic factors include shoulder pain and alternative diagnosis not suggested by provocative maneuvers. […] Risk factors include age 40 to 70 years, diabetes mellitus, prior history of adhesive capsulitis, and previous shoulder surgery. […] 1st tests to order include plain film radiographs and ultrasound. […] Tests to consider include MRI/MR arthrogram shoulder and CT arthrogram.

• #1 Frozen shoulder (adhesive capsulitis) – UpToDate

  https://www.uptodate.com/contents/frozen-shoulder-adhesive-capsulitis

  Frozen shoulder has been defined by the American Academy of Orthopedic Surgeons as „a condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings other than osteopenia are absent.” The condition is also characterized by severe shoulder pain. […] This topic will review the diagnosis and management of frozen shoulder. […] Frozen shoulder occurs predominantly unilaterally and is usually self-limited, although evidence about prognosis is limited, and the course can be prolonged, in some cases lasting over two to three years. […] Patients with type 1 diabetes often have a more prolonged course and are more resistant to therapy. […] Frozen shoulder can be primary (or idiopathic) but is often associated with other diseases and conditions. Patients with diabetes mellitus are at greater risk of developing frozen shoulder.

• #1 Frozen shoulder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684

  Frozen shoulder occurs when the connective tissue enclosing the joint thickens and tightens. […] Frozen shoulder, also called adhesive capsulitis, involves stiffness and pain in the shoulder joint. […] Treatment for frozen shoulder involves range-of-motion exercises. […] The shoulder joint is enclosed in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. […] It’s unclear why this happens to some people. But it’s more likely to happen after keeping a shoulder still for a long period, such as after surgery or an arm fracture. […] People who’ve had to keep a shoulder somewhat still are at higher risk of developing frozen shoulder. […] If you’ve had an injury that makes it difficult to move your shoulder, talk to your health care provider about exercises that can help you maintain your ability to move your shoulder joint.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Frozen-Shoulder-Diagnosis.aspx

  A diagnosis of frozen shoulder is usually based on the classic symptoms of pain and stiffness in the shoulder. […] Diagnosing the condition early on is important as corrective physiotherapy and shoulder exercises can protect the shoulder from further stiffening and damage. […] This helps to prevent progression of the condition and preserve some range of motion in the shoulder. Early diagnosis and treatment also helps to prevent long-term damage and permanently restricted shoulder movement. […] The diagnosing physician examines the shoulder and asks the patient about their symptoms including when they started and how severe the pain is. […] The physician performs a physical examination of the shoulder to assess the range of motion in the arm and shoulder. […] Imaging studies such as X-ray, ultrasound scan and magnetic resonance imaging may be used to check for abnormalities and rule out other problems such as arthritis or a torn tendon.

• #1 Frozen Shoulder: Symptoms, Causes and Treatments – Dr. Beth E. Shubin Stein M.D.

  https://www.drbethshubinstein.com/frozen-shoulder-symptoms-causes-and-treatments/

  A doctor can diagnose frozen shoulder based on a patients description of when symptoms began and when the pain occurs, as well as by doing a physical exam. Identifying loss of active motion (voluntarily being able to move the affected arm and shoulder in certain directions) and loss of passive motion (when the physician tries unsuccessfully to move the arm/shoulder in different directions) is key to making the proper diagnosis, Warner says. An X-ray is taken to rule out the possibility of arthritis in the shoulder causing the limited motion. […] To maximize recovery from frozen shoulder, early diagnosis is important, experts say. If shoulder pain is waking you up at night, if youre losing range of motion (especially when rotating your shoulder inward), or if fast motions with your upper arm hurt more than slow motions, see a doctor. Early intervention and diligent treatment make this a much quicker process if we catch it before scarring occurs, Shubin Stein says.

• #1 Frozen Shoulder: Signs, Causes, Diagnosis & TreatmentVisit our FacebookVisit our InstagramVisit our TwitterVisit our LinkedInclosemenuchevron-downlinkedinfacebookpinterestyoutubersstwitterinstagramfacebook-blankrss-blanklinkedin-blankpinterestyoutubetwitt

  https://ortho-surgeon.com/frozen-shoulder-signs-causes-diagnosis-treatment/

  How is a frozen shoulder diagnosed? […] Seeing a doctor is essential if you think you have a frozen shoulder. They will ask you questions about your symptoms and examine your shoulder. Here are some typical steps in the diagnosis: […] Medical History: The doctor will ask about your symptoms when they started, and if you have had any injuries or surgeries. […] Physical Examination: The doctor will check how far you can move your shoulder. They may ask you to raise your arm, rotate it, or reach in different directions. […] Imaging Tests: Sometimes, doctors use imaging tests like X-rays or MRIs to determine whether there are other problems in the shoulder joint. […] Joint Injections: A numbing agent is temporarily injected into the shoulder joint to relieve pain and stiffness. If the injection provides significant relief, it can indicate that the pain is coming from the shoulder joint and support the diagnosis of a frozen shoulder. […] Frozen Shoulder Grading System: This system categorizes frozen shoulders into three stages: the freezing stage, the frozen stage, and the thawing stage. It can also help track the condition’s progression and develop a treatment plan.

• #1 Overcoming A Frozen Shoulder: What to know about this common diagnosis

  https://www.sralab.org/articles/blog/overcoming-frozen-shoulder-what-know-about-common-diagnosis

  Typically affecting people between the ages of 40 and 60, „frozen shoulder” is a condition marked by stiffness of the shoulder joint capsule, a bag-like structure that surrounds the ball and socket of the shoulder joint. When the capsule becomes stiff, it severely limits shoulder motion. […] Diagnosis with frozen shoulder can be confusing: the good news is that it can be treated, however full recovery can take anywhere from a year to three years. […] The good news is frozen shoulder does not last forever; most people will regain all of their shoulder flexibility (a small percentage of people will continue to have mild stiffness in their shoulder for up to four years, though it tends not to limit daily activities).

• #2 Adhesive Capsulitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0301/p297.html

  Adhesive capsulitis, also known as frozen shoulder, is a common shoulder condition characterized by pain and decreased range of motion, especially in external rotation. […] Although imaging is not necessary to make the diagnosis, a finding of coracohumeral ligament thickening on noncontrast magnetic resonance imaging yields high specificity for adhesive capsulitis. […] A 2017 study concluded that adhesive capsulitis can be accurately and consistently diagnosed with noncontrast magnetic resonance imaging (MRI) of the shoulder in conjunction with appropriate clinical criteria. […] MRI findings of coracohumeral ligament thickening, rotator interval infiltration of the subcoracoid fat, and axillary recess thickening yield high specificity for adhesive capsulitis. […] However, the diagnosis of adhesive capsulitis is a clinical diagnosis and the use of MRI should be reserved for the evaluation of other sources of shoulder pathology, not to confirm a diagnosis of adhesive capsulitis.

• #2 Frozen Shoulder: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/a-to-z-guides/what-is-a-frozen-shoulder

  There’s no specific frozen shoulder test. To diagnose it, your doctor will give you a physical exam. You’ll move your arm in different ways to see how much how it hurts. They may also move your shoulder for you and note the differences. […] A physical exam is usually all your doctor needs to diagnose frozen shoulder. But they might order imaging tests such as X-rays, ultrasound, or MRI to rule out other problems like arthritis or a torn rotator cuff.

• #2 Diagnosing Frozen Shoulder | NYU Langone Health

  https://nyulangone.org/conditions/frozen-shoulder/diagnosis

  NYU Langone doctors are experts in diagnosing frozen shoulder, also called adhesive capsulitis. […] To diagnose frozen shoulder, your NYU Langone doctor asks about your symptoms and determines if you have any health conditions that may put you at risk. He or she also performs the following tests. […] Your doctor evaluates range of motion as you move your arm and shoulder and then as he or she moves your arm for you. Most people with frozen shoulder have difficulty extending the arm upward, away from the body, and lowering it again. […] Sometimes, an X-ray is used to rule out other conditions that can affect the shoulder, such as bursitis. […] Your doctor may use ultrasound to look for tears in the rotator cuff, a group of muscles and tendons that connect the humerus to the shoulder blade. […] An MRI scan uses a powerful magnetic field and radio waves to create images of soft tissues inside the body. It can detect rotator cuff tears and determine if a tear is partial or complete.

• #2 Frozen Shoulder – Adhesive Capsulitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/frozen-shoulder/

  Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. […] After discussing your symptoms and medical history, your doctor will examine your shoulder. […] Your doctor will move your shoulder carefully in all directions to see if movement is limited and if pain occurs with the motion. The range of motion when someone else moves your shoulder is called „passive range of motion.” […] Your doctor will compare this to the range of motion you display when you move your shoulder on your own („active range of motion”). People with frozen shoulder have limited range of motion both actively and passively. […] Other tests that may help your doctor rule out other causes of stiffness and pain include: […] X-rays. Dense structures, such as bone, show up clearly on X-rays. In addition, X-rays may show other problems in your shoulder, such as arthritis. […] Magnetic resonance imaging (MRI) and ultrasound. These imaging tests can create better images of soft tissues than X-rays. They are not required to diagnose frozen shoulder; however, they may help to identify other soft tissue injuries in your shoulder, such as a rotator cuff tear.

• #2 Adhesive Capsulitis (Frozen Shoulder): Practice Essentials, Problem, Epidemiology

  https://emedicine.medscape.com/article/1261598-overview

  Adhesive capsulitis and frozen shoulder syndrome (FSS) are two terms that have been used to describe a painful and stiff shoulder. The current consensus definition of a frozen shoulder by the American Shoulder and Elbow Surgeons is „a condition of uncertain etiology characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.” The American Academy of Orthopaedic Surgeons defines this condition as: „A condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings other than osteopenia are absent.” […] The loss of passive range of motion (ROM) is a critical element in establishing the diagnosis of a true frozen shoulder.

• #2 Idiopathic frozen shoulder

  https://www1.racgp.org.au/ajgp/2019/november/idiopathic-frozen-shoulder

  Confirming that external rotation is not possible with both active and passive movement is important in making the diagnosis. […] A key element in making the correct diagnosis is being able to differentiate limitation of shoulder movement secondary to pain, which is very common in most musculoskeletal conditions, versus limitation secondary to actual physical or mechanical restrictions. […] The pathognomonic sign of frozen shoulder is almost complete loss of active and passive external rotation. […] It is essential to be able to differentiate between limited range of movement secondary to a mechanical block due to glenohumeral capsular tightness and restriction, and limitation secondary to pain. […] Intra-articular corticosteroid injections are safe and effective and have been shown to hasten improvement in pain and function.

• #2 Frozen Shoulder Test — Objective Exam And DDx

  https://www.physio-network.com/blog/frozen-shoulder-instalment-2-objective-examination-and-ddx/

  Frozen shoulder IS a clinical diagnosis, so it is vital you are able to distinguish between a painful shoulder of rotator cuff (etc.) origin and a painful shoulder that is being driven by the complex pathophysiology of frozen shoulder. Correct and timely diagnosis, therefore, leads to timely and accurate intervention. […] As there is no definitive gold standard test to diagnose FS the clinical examination becomes an integral component of the battery of diagnostic tests available. […] Zuckerman and Rokito 2011 state FS is a condition characterized by functional restriction of both active and passive shoulder motion for which radiographs of the glenohumeral joint are unremarkable except for humeral head osteopenia and possible calcific tendinopathy. […] There is NO gold standard test for the diagnosis of FS. Bunker 2009 describes a simple diagnostic criterion for FS; an equal restriction of active and passive glenohumeral external rotation and an essentially normal shoulder radiograph.

• #2 Frozen Shoulder / Adhesive Capsulitis | Diagnosis & Treatment

  https://www.physiotutors.com/conditions/frozen-shoulder/

  Frozen shoulder (FS) is a poorly understood condition that typically involves substantial pain, movement restriction, and considerable morbidity. […] Frozen shoulder is also known as adhesive capsulitis, however, the evidence for capsular adhesions is refuted and arguably this term should be abandoned (Lewis et al. 2015). […] FS can be differentiated into primary (idiopathic onset) and secondary onset. […] An MRI study by Lee et al. (2012) confirmed this by showing that the coracohumeral ligament and the capsule in axillary recess were significantly greater in patients with Frozen Shoulder compared to a healthy control group. […] Hollmann et al. (2015) did a study on the amount of active muscle guarding in patients suspected to have FS and found that all patients had experienced a huge increase in passive abduction while under anesthesia. […] For this reason, it can make sense to perform the Coracoid Pain Test to distinguish between a real and pseudo-Frozen Shoulder (Carbone et al. 2010). […] Another orthopedic test to distinguish Frozen Shoulder from other shoulder pathologies is the Shoulder Shrug Sign.

• #2 Frozen Shoulder: Signs, Causes, Diagnosis & TreatmentVisit our FacebookVisit our InstagramVisit our TwitterVisit our LinkedInclosemenuchevron-downlinkedinfacebookpinterestyoutubersstwitterinstagramfacebook-blankrss-blanklinkedin-blankpinterestyoutubetwitt

  https://ortho-surgeon.com/frozen-shoulder-signs-causes-diagnosis-treatment/

  How is a frozen shoulder diagnosed? […] Seeing a doctor is essential if you think you have a frozen shoulder. They will ask you questions about your symptoms and examine your shoulder. Here are some typical steps in the diagnosis: […] Medical History: The doctor will ask about your symptoms when they started, and if you have had any injuries or surgeries. […] Physical Examination: The doctor will check how far you can move your shoulder. They may ask you to raise your arm, rotate it, or reach in different directions. […] Imaging Tests: Sometimes, doctors use imaging tests like X-rays or MRIs to determine whether there are other problems in the shoulder joint. […] Joint Injections: A numbing agent is temporarily injected into the shoulder joint to relieve pain and stiffness. If the injection provides significant relief, it can indicate that the pain is coming from the shoulder joint and support the diagnosis of a frozen shoulder. […] Frozen Shoulder Grading System: This system categorizes frozen shoulders into three stages: the freezing stage, the frozen stage, and the thawing stage. It can also help track the condition’s progression and develop a treatment plan.

• #2 Frozen Shoulder (Adhesive Capsulitis): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/frozen-shoulder-adhesive-capsulitis

  To diagnose frozen shoulder (adhesive capsulitis), your healthcare provider will discuss your symptoms and review your medical history. Theyll also perform a physical exam of your arms and shoulders. Theyll: […] Your provider will likely order shoulder X-rays to make sure the cause of your symptoms isnt due to another problem with your shoulder, like arthritis. You usually dont need advanced imaging tests like magnetic resonance imaging (MRI) and ultrasound to diagnose frozen shoulder. But your provider may request them to look for other problems, like a rotator cuff tear.

• #2 Signs, Symptoms, and Treatment of Frozen Shoulder | OrthoVirginiaSearch

  https://www.orthovirginia.com/blog/signs-symptoms-and-treatment-of-frozen-shoulder/

  For diagnosis of a frozen shoulder, we will often start with x-rays. […] An x-ray won’t tell us as physicians if you have frozen shoulder, but it will show us if you have impingement, rotator cuff problems, arthritis, calcific tendonitis, and so on. […] The physical exam is what will help determine if you have frozen shoulder. One of the classic things I see on a physical exam for a frozen shoulder is that you lose external rotation, which is when you move your arm out to the side. […] If you’ve really plateaued and are not improving after six to eight weeks of physical therapy, an MRI may be ordered by your physician to look at the details of the ligaments, tendons, cartilage, and bone.

• #2 Frozen Shoulder (Capsulitis) Risk Factors & Treatments | HSS

  https://www.hss.edu/condition-list_frozen-shoulder.asp

  Your doctor will take your medical history, have you describe your symptoms and conduct a physical exam, including testing your range of motion. […] A magnetic resonance imaging (MRI) exam is often needed to confirm the diagnosis by distinguishing it from other conditions that have similar symptoms, such as shoulder arthritis or calcific tendonitis. […] An MRI of a shoulder with adhesive capsulitis will display significant thickening of the joint capsule.

• #2 Idiopathic frozen shoulder

  https://www1.racgp.org.au/ajgp/2019/november/idiopathic-frozen-shoulder

  The primary care physician plays a pivotal part in the identification and management of idiopathic frozen shoulder, with the vast majority of patients responding to conservative management. […] The majority of patients with shoulder pain are seen and treated in primary care settings, placing the primary care physician in a pivotal role for the diagnosis and management of this condition. […] Frozen shoulder is predominantly a clinical diagnosis. […] Most imaging modalities and pathology testing that aim to confirm the diagnosis are usually unhelpful and may result in the wrong diagnosis being made. […] The patient presenting with idiopathic frozen shoulder is characterised by the spontaneous onset of pain with significant restriction of both active and passive range of movement of the shoulder.

• #2 Diagnosis of the Frozen Shoulder | UW Orthopaedic Surgery and Sports Medicine

  https://orthop.washington.edu/patient-care/articles/shoulder/diagnosis-of-the-frozen-shoulder.html

  The necessary and sufficient criteria for the diagnosis of a frozen shoulder are: […] A. History […] Functionally significant restriction of shoulder motion […] Absence of history of previous major shoulder injury or surgery […] B. Physical examination […] Limited glenohumeral motion in all directions […] C. Radiographs […] No changes in cartilaginous joint space […] Absence of pathological changes other than osteopenia.

• #2 Overcoming A Frozen Shoulder: What to know about this common diagnosis

  https://www.sralab.org/articles/blog/overcoming-frozen-shoulder-what-know-about-common-diagnosis

  Typically affecting people between the ages of 40 and 60, „frozen shoulder” is a condition marked by stiffness of the shoulder joint capsule, a bag-like structure that surrounds the ball and socket of the shoulder joint. When the capsule becomes stiff, it severely limits shoulder motion. […] Diagnosis with frozen shoulder can be confusing: the good news is that it can be treated, however full recovery can take anywhere from a year to three years. […] The good news is frozen shoulder does not last forever; most people will regain all of their shoulder flexibility (a small percentage of people will continue to have mild stiffness in their shoulder for up to four years, though it tends not to limit daily activities).

• #2 Frozen Shoulder Diagnosis | How to assess Frozen Shoulder

  https://www.physiotutors.com/wiki/frozen-shoulder-diagnosis/

  Frozen shoulder has a prevalence of 2%-5.3% in the general population with a peak at 55 years of age and a higher prevalence amongst women patients with diabetes and thyroid dysfunction and a previous episode of Frozen shoulder on the contralateral side. […] The stiff and painful shoulder is identified by a significant and equal loss of both active and passive shoulder movements but has minimal pain on resisted testing. […] To diagnose Frozen shoulder in your physical examination the first examine external rotation in the zero position and compare it to the other side. […] An external rotation loss of at least 50% compared to the other side or less than 30 is considered a positive finding. […] According to a study done by Holman et al. (2015), all patients suspected of frozen shoulder displayed some degree of active muscle guarding. […] For this reason, it might be helpful to perform the coracoid pain test to distinguish between a true and a pseudo frozen shoulder. […] Another orthopedic test for Frozen Shoulder is the Shoulder Shrug Sign.

• #2 Frozen shoulder | healthdirect

  https://www.healthdirect.gov.au/frozen-shoulder

  Frozen shoulder can be managed with a combination of pain relief strategies, physiotherapy, joint injections and sometimes surgery. […] Your doctor will ask about your symptoms, medical history and any recent injuries. They will examine your shoulder to check for pain and range of motion. Usually special tests, including imaging tests such as x-ray, are not needed to diagnose frozen shoulder. […] If your doctor diagnoses frozen shoulder, they may check for other conditions associated with frozen shoulder, such as diabetes, high blood pressure and high cholesterol.

• #2 Frozen Shoulder: Symptoms, Causes and Treatments – Dr. Beth E. Shubin Stein M.D.

  https://www.drbethshubinstein.com/frozen-shoulder-symptoms-causes-and-treatments/

  A doctor can diagnose frozen shoulder based on a patients description of when symptoms began and when the pain occurs, as well as by doing a physical exam. Identifying loss of active motion (voluntarily being able to move the affected arm and shoulder in certain directions) and loss of passive motion (when the physician tries unsuccessfully to move the arm/shoulder in different directions) is key to making the proper diagnosis, Warner says. An X-ray is taken to rule out the possibility of arthritis in the shoulder causing the limited motion. […] To maximize recovery from frozen shoulder, early diagnosis is important, experts say. If shoulder pain is waking you up at night, if youre losing range of motion (especially when rotating your shoulder inward), or if fast motions with your upper arm hurt more than slow motions, see a doctor. Early intervention and diligent treatment make this a much quicker process if we catch it before scarring occurs, Shubin Stein says.

• #2 Adhesive Capsulitis (Frozen Shoulder): Practice Essentials, Problem, Epidemiology

  https://emedicine.medscape.com/article/1261598-overview

  Patients with primary frozen shoulder have no significant findings in the history, clinical examination, or radiographic evaluation to explain their motion loss and pain. […] The inclusion criteria for FSS include painful restriction of active and passive glenohumeral and/or periscapular motion. […] Despite these criteria, diagnosing FSS can be controversial because there is little consensus on the specific shoulder motion restrictions or duration of symptoms needed to qualify a patient as having a frozen shoulder. Although various authors have classified patients with FSS as those with limited abduction from 45-135, FSS is still primarily a clinical diagnosis based on clinical motion loss and symptoms.

• #2 Frozen Shoulder Test — Objective Exam And DDx

  https://www.physio-network.com/blog/frozen-shoulder-instalment-2-objective-examination-and-ddx/

  No blood tests to confirm the presence of FS is available, however may assist in developing a causal relationship between diabetes or hypothyroidism. […] In relation to imaging, radiographs are typically normal and can help to exclude osteoarthritis, locked dislocation or sinister pathology as a cause of pain. […] Yoon et al 2017 argued that MRI can identify characteristic patho-anatomical features associated with FS, such as greater thickening and enhancement of the capsule and axillary recess and greater thickening of the soft tissue of the rotator interval. However, it was deemed the MRI findings were not relevant or able to predict prognosis or severity of symptoms. Therefore, whilst MRI may be helpful in identifying consistent patho-anatomical structures, it is not necessary in the diagnosis of FS.

• #2 Adhesive capsulitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1043

  Other diagnostic factors include the presence of risk factors, shoulder pain, and alternative diagnosis not suggested by provocative manoeuvres. […] 1st investigations to order include plain film radiographs and ultrasound. […] Investigations to consider include MRI/MR arthrogram shoulder and CT arthrogram.

• #2 How to diagnose frozen shoulder: Cure and treatment | CK Birla Hospital

  https://www.ckbhospital.com/blogs/diagnose-frozen-shoulder/

  Often pain in the shoulder is inappropriately given a blanket diagnosis of frozen shoulder. […] However, it is not enough to have untargeted physical therapy without proper diagnosis. […] In this article, Dr Reetadyuti, the best shoulder specialist in Gurgaon, offers a complete guide of what is frozen shoulder and how to diagnose frozen shoulder. […] Your healthcare provider will discuss your medical history with you. He/she will ask you about the symptoms, the first time you noticed pain and stiffness and the effect of symptoms in your routine. […] A general physical exam and frozen shoulder test are enough to diagnose frozen shoulder. […] There are three essential elements of a frozen shoulder test. […] Your shoulder specialist may also order some imaging tests such as X-rays and MRI scans to rule out the possibility of other musculoskeletal conditions such as arthritis or rotator cuff tear. […] A timely and proper diagnosis is crucial to care for a frozen shoulder.

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