Shoulder girdle neoplasm misdiagnosis and clinical manifestations: A scoping review

The aim of this review is to outline the clinical presentation of patients with shoulder girdle neoplasm to help differentiate it from frozen shoulder contracture syndrome (FSCS) as well as quantify misdiagnosis rates in the literature.

Four electronic databases were searched (Embase, Medline, PUBMED and Scopus) for cohort studies of patients with shoulder girdle neoplasm with or without misdiagnosis as FSCS in line with the PRISMA-ScR guidelines for scoping reviews.

The initial search yielded 2462 studies, 10 of which were included in the final review. The most common symptom of patients with shoulder girdle neoplasm was shoulder pain (62%) followed by swelling/mass/deformity (34%) and local/bony tenderness (13%). In patients with neoplasm initially misdiagnosed as FSCS the main complaints were shoulder pain and subjective stiffness/loss of range of motion (73% each). Misdiagnosis rates ranged from 10% to 50% and resulted in diagnostic delays of up to 30 months.

Key clinical features of bone and soft tissue tumours such as local bony tenderness and careful observation for swelling/mass/deformity should be included in the physical examination to help differentiate between the two pathologies and help guide the choice of initial imaging for the primary contact clinician.