From the Research
Frozen shoulder is diagnosed based on a combination of clinical presentation and physical examination findings, with the primary diagnostic criteria including progressive shoulder pain and significant restriction in both active and passive range of motion in at least two planes, particularly external rotation and abduction, as supported by the most recent study 1. The diagnosis of frozen shoulder, also known as adhesive capsulitis, involves a thorough evaluation of the patient's symptoms and physical examination results. The condition is characterized by three overlapping phases:
- the painful freezing phase,
- the adhesive or frozen phase, and
- the thawing phase. Physical examination reveals limited glenohumeral movement in all directions with a firm endpoint, while preserving scapulothoracic motion. Imaging, such as plain radiographs or MRI, may be used to exclude other conditions, but is not required for diagnosis, as stated in the study 2. The diagnosis is often one of exclusion, ruling out conditions like rotator cuff pathology, glenohumeral arthritis, and calcific tendinitis. Risk factors for frozen shoulder include diabetes, thyroid disorders, stroke, and prolonged immobilization, as identified in the study 1. The condition is more common in women and typically affects people between 40-60 years of age. Key diagnostic criteria include:
- Progressive shoulder pain
- Significant restriction in both active and passive range of motion in at least two planes
- Limited glenohumeral movement in all directions with a firm endpoint
- Preservation of scapulothoracic motion
- Exclusion of other conditions through imaging or physical examination, as recommended in the study 3. The most recent and highest quality study 1 provides a comprehensive overview of the diagnostic criteria and risk factors for frozen shoulder, and should be consulted for guidance on diagnosis and management.