The pathology of frozen shoulder. A Dupuytren-like disease

Bunker, Tim; Anthony, PP

doi:10.1302/0301-620x.77b5.7559688

Cited by 467 publications

(353 citation statements)

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“…After the first description by Duplay in 1872 [1], it was better described by Codman [2] as "frozen shoulder"; however, it was only in 1945 that Neviaser [3] coined the term "adhesive capsulitis", after a cadaveric study, in which he found that the capsule was thickened and highly adherent to the humeral head while the bursa was unaffected, suggesting a chronic inflammatory condition. However, Lundberg et al [4] as well as Bunker et al [5] found no significant inflammatory cells and reported that the morphology of the contracted tissue was similar to that of Dupuytren's contracture. In 1975 Reeves et al [6] proposed three different phases to stage the disease: the painful phase, the frozen phase, and the thawing phase, with an overall estimated duration varying from 12 to 42 months.…”

Section: Introductionmentioning

confidence: 92%

Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections?

Carli¹,

Vadalà²,

Perugia³

et al. 2011

International Orthopaedics (SICOT)

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Purpose The aim of this study was to compare shoulder manipulation and arthroscopic arthrolysis with glenohumeral steroid injections in patients affected by idiopathic adhesive shoulder capsulitis. Methods In this prospective study we randomly assigned patients to enter group A (23 patients, shoulder manipulation and arthroscopic arthrolysis) and group B (21 patients, glenohumeral steroid injections). Patients were followed-up at three, six and 12 weeks, and at six and 12 months with the Constant and Murley, ASES, UCLA and SST evaluation scales. Moreover, passive forward flexion, abduction, and internal and external rotations were recorded.

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Section: Introductionmentioning

confidence: 92%

Shoulder adhesive capsulitis: manipulation and arthroscopic arthrolysis or intra-articular steroid injections?

Carli¹,

Vadalà²,

Perugia³

et al. 2011

International Orthopaedics (SICOT)

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“…18,19,64,115 Numerous investigators report the visual presence of synovitis consistent with inflammation, 43,79,83,123 yet focal vascularity and synovial angiogenesis (increased papillary growth), rather than synovitis, are described by others. 18,50,124 In addition to confirmation of angiogenesis, frequent positive staining for nerve cells was found in patients with frozen shoulder. 42 However, if the synovial pathology is angiogenesis or synovitis, there is agreement that pain accompanies the change.…”

Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

“…103 A greater than 50% reduction in passive external rotation or less than 30° of external rotation, when measured with the arm at the side, is a common finding in individuals with frozen shoulder. 8,15,18,24,39,78,96,100,107,119,121 Although authors of textbooks have described patients with frozen shoulder as having normal strength and painless resisted motions, 24 authors of recent studies, using handheld dynamometry, have revealed significant weakness of the shoulder internal rotators 53,59 and elevators 53,59,111 in these patients. The shoulder internal rotators were significantly weaker in patients with frozen shoulder compared to patients with rotator cuff tendinopathy; however, significant weakness of the external rotators and abductors was also found relative to the uninvolved side.…”

Section: Level 5 J Orthop Sportsmentioning

confidence: 99%

Frozen Shoulder: Evidence and a Proposed Model Guiding Rehabilitation

Kelley¹,

McClure²,

Leggin³

2009

J Orthop Sports Phys Ther

207

171

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Frozen shoulder, or adhesive capsulitis, describes the common shoulder condition characterized by painful and limited active and passive range of motion (ROM). Frozen shoulder is reported to affect 2% to 5% of the general population, 4,13,64,88 increasing to 10% to 38% in patients with diabetes and thyroid disease. 4,5,13,64,71,88 Individuals with primary frozen shoulder are commonly between 40 and 65 years old, 79,82,83 and the incidence appears higher in females than males. 4,9,43,64,71,109 The occurrence of frozen shoulder in 1 shoulder increases the risk of contralateral shoulder involvement by 5% to history, clinical presentation, and recovery. Codman 22 described frozen shoulder as "a condition difficult to define, difficult to treat, and difficult to explain from the point of view of pathology." Nevaiser 80 introduced the term adhesive capsulitis to describe the inflamed and fibrotic condition of the capsuloligamentous tissue. The term frozen shoulder will be used, because it encompasses both primary frozen shoulder (adhesive capsulitis) and secondary frozen shoulder related to systemic disease and extrinsic or intrinsic factors, excluding cerebral vascular accident, proximal humeral fracture, and causative rotator cuff or labral pathology. This paper will present an overview of the classification, etiology, pathology, examination, and plan of care for frozen shoulder.T he absence of standardized nomenclature for frozen shoulder causes confusion in the literature. Lundberg 64 first described a classification system identifying primary frozen shoulder as idiopathic and secondary frozen shoulder as posttraumatic. Nash and Hazelman 77 expanded the classification system by including diseases such as diabetes mellitus, myocardial infarction, or various neurologic disorders under secondary frozen shoulder. Zuckerman 128 proposed a classification schema where primary 34%, and simultaneous bilateral shoulder involvement occurs as often as 14% of the time. 16,39,64,107 To date, the etiology of frozen shoulder remains unclear; however, patients typically demonstrate a characteristic Frozen shoulder or adhesive capsulitis describes the common shoulder condition characterized by painful and limited active and passive range of motion. The etiology of frozen shoulder remains unclear; however, patients typically demonstrate a characteristic history, clinical presentation, and recovery. A classification schema is described, in which primary frozen shoulder and idiopathic adhesive capsulitis are considered identical and not associated with a systemic condition or history of injury. Secondary frozen shoulder is defined by 3 subcategories: systemic, extrinsic, and intrinsic. We also propose another classification system based on the patient's irritability level (low, moderate, and high), that we believe is helpful when making clinical decisions regarding rehabilitation intervention. Nonoperative interventions include patient education, modalities, stretching exercises, joint mobilization, and corticosteroid injections. Gle...

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“…In the more common idiopathic primary frozen shoulder, it is characterised by an inflammatory contracture of the glenohumeral synovial capsule as well as other extra-articular softtissue structures such as the coracohumeral ligament, soft tissues of the rotator interval, the subscapularis muscle, and the subacromial bursae as a result of hyperplastic fibroplasia and excessive type III collagen secretion. 10 This reduces the available intra-articular volume thus limiting glenohumeral movement. Although generally considered self-limiting, it can lead to long-term disability and pain.…”

Section: Discussionmentioning

confidence: 99%