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Shoulder stiffness: diagnosis.
Divya Bhargav1, George A Murrell
1Sports Medicine and Shoulder Service, Orthopaedic Research Institute, University of New South Wales, St George Hospital Campus, Sydney, New South Wales.
Australian Family Physician
|April 2, 2004
Summary
Idiopathic capsulitis, or frozen shoulder, is a common cause of shoulder stiffness in adults. Clinical evaluation effectively differentiates it from rotator cuff tears and impingement.
Area of Science:
- Orthopedics
- Sports Medicine
- Anatomy
Background:
- Shoulder pain and stiffness are prevalent, especially in individuals aged 40-80.
- Idiopathic capsulitis, commonly known as frozen shoulder, is the leading cause of shoulder stiffness in the fifth decade of life.
Purpose of the Study:
- To review the functional anatomy of the shoulder.
- To outline the pathology of shoulder stiffness conditions.
- To present methods for differentiating these conditions.
Main Methods:
- Clinical history and physical examination.
- Radiographic assessment (X-rays).
- Diagnostic ultrasound.
Main Results:
- Clinical assessment accurately distinguishes rotator cuff tears, impingement, and frozen shoulder.
- Restricted glenohumeral motion, especially external rotation, without X-ray abnormalities suggests frozen shoulder.
- X-rays are crucial for detecting glenohumeral arthritis.
Conclusions:
- Clinical evaluation is sufficient for diagnosing common shoulder stiffness causes.
- Imaging modalities like ultrasound aid in complex cases or when clinical diagnosis is uncertain.