Glenohumeral joint tuberculosis that mimics frozen shoulder: a retrospective analysis

2012 ◽  
Vol 21 (9) ◽  
pp. 1207-1212 ◽  
Author(s):  
Jin-qing Li ◽  
Kang-lai Tang ◽  
Hao-tong Xu ◽  
Qi-yu Li ◽  
Shao-xiang Zhang
Keyword(s):  
Retrospective Analysis ◽  
Glenohumeral Joint ◽  
Frozen Shoulder

scholarly journals Pain-related beliefs are associated with arm function in persons with frozen shoulder

2020 ◽  
Vol 12 (6) ◽  
pp. 432-440
Author(s):  
L De Baets ◽  
T Matheve ◽  
J Traxler ◽  
JWS Vlaeyen ◽  
A Timmermans
Keyword(s):  
Pain Intensity ◽  
Self Efficacy ◽  
Glenohumeral Joint ◽  
Pain Catastrophizing ◽  
Frozen Shoulder ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Negative Effect ◽  
Explained Variance ◽  
Arm Function

Background Frozen shoulder is a painful glenohumeral joint condition. Pain-related beliefs are recognized drivers of function in musculoskeletal conditions. This cross-sectional study investigates associations between pain-related beliefs and arm function in frozen shoulder. Methods Pain intensity, arm function (Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), pain-related fear (Tampa Scale for Kinesiophobia (TSK-11)) and pain self-efficacy (Pain Self-Efficacy Questionnaire (PSEQ)) were administered in 85 persons with frozen shoulder. Correlation analyses assessed associations between pain-related beliefs and arm function. Regression analysis calculated the explained variance in arm function by pain-related beliefs. Results Pain-related fear, pain catastrophizing and pain self-efficacy were significantly associated with arm function (r = 0.51; r = 0.45 and r = −0.69, all p < .0001, respectively). Thirty-one percent of variance in arm function was explained by control variables, with pain intensity being the only significant one. After adding TSK-11, PCS and PSEQ scores to the model, 26% extra variance in arm function was explained, with significant contributions of pain intensity, pain-related fear and pain self-efficacy (R2 = 0.57). Conclusions Attention should be paid towards the negative effect of pain-related fear on outcomes in frozen shoulder and towards building one’s pain self-efficacy given its protective value in pain management.

scholarly journals Changes in Abduction and Rotation Range of Motion in Response to Simulated Dorsal and Ventral Translational Mobilization of the Glenohumeral Joint

2002 ◽  
Vol 82 (6) ◽  
pp. 544-556 ◽  
Author(s):  
Ar-Tyan Hsu ◽  
Tom Hedman ◽  
Jia Hao Chang ◽  
Chuong Vo ◽  
Larry Ho ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Glenohumeral Joint ◽  
Physical Therapists ◽  
Frozen Shoulder ◽  
Testing System ◽  
Before And After ◽  
Medial Rotation ◽  
Fresh Frozen ◽  
Lateral Rotation ◽  
Improved Function

AbstractBackground and Purpose. Translational mobilization techniques are frequently used by physical therapists as an intervention for patients with limited ranges of motion (ROMs). However, concrete experimental support for such practice is lacking. The purpose of the study was to evaluate the effect of simulated dorsal and ventral translational mobilization (DTM and VTM) of the glenohumeral joint on abduction and rotational ROMs. Methods. Fourteen fresh frozen shoulder specimens from 5 men and 3 women (mean age=77.3 years, SD=10.1, range=62–91) were used for this study. Each specimen underwent 5 repetitions of DTM and VTM in the plane of scapula simulated by a material testing system (MTS) in the resting position (40° of abduction in neutral rotation) and at the end range of abduction with 100 N of force. Abduction and rotation were assessed as the main outcome measures before and after each mobilization procedure performed and monitored by the MTS (abduction, 4 N·m) and by a servomotor attached to the piston of the actuator of the MTS (medial and lateral rotation, 2 N·m). Results. There were increases in abduction ROM for both DTM (X̄=2.10°, SD=1.76°) and VTM (X̄=2.06°, SD=1.96°) at the end-range position. No changes were found in the resting position following the same procedure. Small increases were also found in lateral rotation ROM after VTM in the resting position (X̄=0.90°, SD=0.92°, t=3.65, P=.003) and in medial rotation ROM after DTM (X̄=0.97°, SD=1.45°, t=2.51, P=.026) at the end range of abduction. Discussion and Conclusion. The results indicate that both DTM and VTM procedures applied at the end range of abduction improved glenohumeral abduction range of motion. Whether these changes would result in improved function could not be determined because of the use of a cadaver model.

scholarly journals Evaluation of the Treatment of Frozen Shoulder by Hydraulic Distention Under

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Shakeel Khan Ghauri ◽  
Muhammad Aftab Anwar ◽  
Asif Hanif ◽  
Muhammad Akram
Keyword(s):  
Pain Relief ◽  
Local Anesthesia ◽  
Glenohumeral Joint ◽  
Frozen Shoulder ◽  
Muscle Relaxants ◽  
Early Results ◽  
Group I ◽  
Normal Sleep ◽  
Group Ii

Objective:  To evaluate the result of treatment of frozen shoulder by Hydraulic Distention under local anesthesia with steroid and intra-articular steroid alone. Study Design:  It was a prospective and comparative study. Samples size:  60 patients were taken in this study and were divided into two groups. Duration and Setting:  The study was conducted in 2000 - 2001  treated in the department of Orthopaedic, Mayo Hospital Lahore. Methodology:  The patients were divided into two groups. Group-I were treated by hydraulic distension of glenohumeral joint with 50 ml normal saline under local anesthesia with steroid followed by medicines (oral analgesics and muscle relaxants) and exercises. Patients in group-II were treated by intra-articular steroid followed by medicines (oral analgesics and muscle relaxants) and exercises. Results:  The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 22 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group-I noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group-II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM. Conclusions:  Hydraulic distension technique is a quick, safe and gives early results, so it should be considered first for the treatment of frozen shoulder. Key Words:  Frozen Shoulder, Hydrologic Distention, Intra articular steroid.

scholarly journals Is the Frozen Shoulder Classification a Reliable Assessment?

2018 ◽  
Vol 21 (2) ◽  
pp. 82-86 ◽  
Author(s):  
Ji Yong Gwark ◽  
Nitesh Gahlot ◽  
Mincheol Kam ◽  
Hyung Bin Park
Keyword(s):  
Glenohumeral Joint ◽  
Systemic Disease ◽  
Frozen Shoulder ◽  
Test Results ◽  
Separate Representation ◽  
Blood Tests ◽  
Reliable Assessment ◽  
Patients With Diabetes ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

BACKGROUND: Although a common shoulder disease, there are no accepted classification criteria for frozen shoulder (FS). This study therefore aimed to evaluate the accuracy of the conventionally used FS classification system.METHODS: Primary FS patients (n=168) who visited our clinic from January 2010 to July 2015 were included in the study. After confirming restrictions of the glenohumeral joint motion and absence of history of systemic disease, trauma, shoulder surgery, shoulder muscle weakness, or specific x-ray abnormalities, the Zuckerman and Rokito's classification was employed for diagnosing primary FS. Following clinical diagnosis, each patient underwent a shoulder magnetic resonance imaging (MRI) and blood tests (lipid profile, glucose, hemoglobin A1c, and thyroid function). Based on the results of the blood tests and MRIs, the patients were reclassified, using the criteria proposed by Zuckerman and Rokito.RESULTS: New diagnoses were ascertained including blood test results (16 patients with diabetes, 43 with thyroid abnormalities, and 149 with dyslipidemia), and MRI revealed intra-articular lesions in 81 patients (48.2%). After re-categorization based on the above findings, only 5 patients (3.0%) were classified having primary FS. The remaining 163 patients (97.0%) had either undiagnosed systemic or intrinsic abnormalities (89 patients), whereas 74 patients had both.CONCLUSIONS: These findings demonstrate that most patients clinically diagnosed with primary FS had undiagnosed systemic abnormalities and/or intra-articular pathologies. Therefore, a modification of the Zuckerman and Rokito's classification system for FS may be required to include the frequent combinations, rather than having a separate representation of systemic abnormalities and intrinsic causes.

A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder

2021 ◽  
Vol 103-B (2) ◽  
pp. 353-359
Author(s):  
Chul-Hyun Cho ◽  
Byung-Woo Min ◽  
Ki-Cheor Bae ◽  
Kyung-Jae Lee ◽  
Du Hwan Kim
Keyword(s):  
Glenohumeral Joint ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Range Of Movement ◽  
Double Blind ◽  
Pain Scores ◽  
The Us ◽  
Time Of Presentation ◽  
Corticosteroid Injections

Aims Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the glenohumeral joint in patients with primary frozen shoulder (FS). Methods Intra-articular corticosteroid injections were administered to 90 patients primary FS, who were randomly assigned to either an US-guided (n = 45) or a blind technique (n = 45), by a shoulder specialist. Immediately after injection, fluoroscopic images were obtained to assess the accuracy of the injection. The outcome was assessed using a visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the subjective shoulder value (SSV) and range of movement (ROM) for all patients at the time of presentation and at three, six, and 12 weeks after injection. Results The accuracy of injection in the US and blind groups was 100% (45/45) and 71.1% (32/45), respectively; this difference was significant (p < 0.001). Both groups had significant improvements in VAS pain score, ASES score, SSV, forward flexion, abduction, external rotation, and internal rotation throughout follow-up until 12 weeks after injection (all p < 0.001). There were no significant differences between the VAS pain scores, the ASES score, the SSV and all ROMs between the two groups at the time points assessed (all p > 0.05). No injection-related adverse effects were noted in either group. Conclusion We found no significant differences in pain and functional outcomes between the two groups, although an US-guided injection was associated with greater accuracy. Considering that it is both costly and time-consuming, an US-guided intra-articular injection of corticosteroid seems not always to be necessary in the treatment of FS as it gives similar outcomes as a blind injection. Cite this article: Bone Joint J 2021;103-B(2):353–359.

scholarly journals Intraarticular injection of relaxin-2 alleviates shoulder arthrofibrosis

2019 ◽  
Vol 116 (25) ◽  
pp. 12183-12192 ◽  
Author(s):  
William A. Blessing ◽  
Stephen M. Okajima ◽  
M. Belen Cubria ◽  
Juan C. Villa-Camacho ◽  
Miguel Perez-Viloria ◽  
...  
Keyword(s):  
Type I Collagen ◽  
Glenohumeral Joint ◽  
Smooth Muscle Actin ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Joint Space ◽  
Intracellular Camp ◽  
Bolus Administration ◽  
Type I ◽  
Relaxin 2

Arthrofibrosis is a prevalent condition affecting greater than 5% of the general population and leads to a painful decrease in joint range of motion (ROM) and loss of independence due to pathologic accumulation of periarticular scar tissue. Current treatment options are limited in effectiveness and do not address the underlying cause of the condition: accumulation of fibrotic collagenous tissue. Herein, the naturally occurring peptide hormone relaxin-2 is administered for the treatment of adhesive capsulitis (frozen shoulder) and to restore glenohumeral ROM in shoulder arthrofibrosis. Recombinant human relaxin-2 down-regulates type I collagen and α smooth muscle actin production and increases intracellular cAMP concentration in human fibroblast-like synoviocytes, consistent with a mechanism of extracellular matrix degradation and remodeling. Pharmacokinetic profiling of a bolus administration into the glenohumeral joint space reveals the brief systemic and intraarticular (IA) half-lives of relaxin-2: 0.96 h and 0.62 h, respectively. Furthermore, using an established, immobilization murine model of shoulder arthrofibrosis, multiple IA injections of human relaxin-2 significantly improve ROM, returning it to baseline measurements collected before limb immobilization. This is in contrast to single IA (sIA) or multiple i.v. (mIV) injections of relaxin-2 with which the ROM remains constrained. The histological hallmarks of contracture (e.g., fibrotic adhesions and reduced joint space) are absent in the animals treated with multiple IA injections of relaxin-2 compared with the untreated control and the sIA- and mIV-treated animals. As these findings show, local delivery of relaxin-2 is an innovative treatment of shoulder arthrofibrosis.

Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis

2020 ◽  
pp. 175857322097717
Author(s):  
Daoud Makki ◽  
Mustafa Al-Yaseen ◽  
Fayaz Almari ◽  
Puneet Monga ◽  
Lennard Funk ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Outcome Measures ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Number Of Patients ◽  
Post Traumatic

Background Adhesive capsulitis (frozen shoulder) is characterised by pain and loss of range of motion of the glenohumeral joint. It can be present as primary (idiopathic) or secondary to surgery, trauma or other conditions that restrict the use of the shoulder joint. Various treatment options have been adopted including physiotherapy, manipulation under anaesthetic, hydrodilatation and arthroscopic or open capsular release but the optimal form of management remains uncertain. Objectives The purpose of the study was to assess the clinical outcome of glenohumeral hydrodilatation in three cohorts of patients with different aetiologies with adhesive capsulitis. Study design & methods We carried out a retrospective study of patient who underwent hydrodilatation for adhesive capsulitis between 2013 and 2015. The procedure was performed by a specialist musculoskeletal radiologist under radiological guidance. The injection consisted of steroids, local anaesthetics and NaCl solution with a target volume around 35 mL. Our outcome measures were range of motion, and pre- and post-operative pain. Patients were divided into three groups based on the presumed cause of their stiffness: idiopathic, post-traumatic and post-surgical. Results Two hundred fifty patients were included, with a mean age of 59 years (range: 20–79). Of these, 180 had idiopathic primary adhesive capsulitis (27 were diabetic), 23 were post-traumatic, and 20 following surgical procedures. Thirty-four required further intervention following initial hydrodilatation with 8 undergoing repeat hydrodilatation, and 26 requiring arthroscopic capsular release. The diabetic group accounted for 16 capsular releases and 4 repeat procedures, while the idiopathic group accounted for 9 and 4, respectively. One patient required capsular release in the surgical group. An improvement was recorded in ROM in all groups with mean abduction improving from 59° to 110°, flexion from 50° to 120° and external rotation from 20° to 50°. With regards to pain, the majority showed an improvement from severe or moderate pain to no or mild pain. Conclusions Results show that hydrodilatation resulted in an improvement in all outcome measures, with only a small number of patients, especially those with diabetes, needing further procedures or showing no improvement in range of motion and pain. There was no difference between the post-traumatic and post-surgical groups.

scholarly journals Dynamic Ultrasonographic Measurement of Inferior Joint Cap-Sule Thickness in Patients with Unilateral Frozen Shoulder

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 898
Author(s):  
Jun-Gyu Lee ◽  
Hyung-Sun Peo ◽  
Jang-Hyuk Cho ◽  
Chul-Hyun Cho ◽  
Don-Kyu Kim ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Glenohumeral Joint ◽  
Frozen Shoulder ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Neutral Position ◽  
Anterior Axillary Line ◽  
Linear Transducer ◽  
The Us ◽  
Good Diagnostic Accuracy

The diagnostic value of ultrasonography (US) for frozen shoulder (FS) is not well established. This study aimed to assess the diagnostic value of US measurement of inferior joint capsule (IJC) thickness and evaluate changes in the thickness of the IJC by US depending on arm position. A total of 71 patients with clinically diagnosed unilateral FS who underwent bilateral US measurement of the IJC were enrolled in this study. The US measurement of the IJC was performed with a linear transducer positioned around the anterior axillary line with the shoulder 40° abducted and with neutral rotation of the glenohumeral joint (neutral position). We also measured the IJC thickness in the externally rotated and internally rotated positions with the shoulder 40° abducted. In the neutral position, as well as in the internally rotated and externally rotated positions, the thickness of the IJC on US was significantly higher in the affected shoulder than that in the unaffected shoulder (all p < 0.001). On both the affected and unaffected sides, the US thickness of the IJC in the neutral position was significantly higher than that in the externally rotated position (p < 0.001), but lower than that in the internally rotated position (p < 0.001). Regarding IJC thickness in the neutral position, a 3.2-mm cutoff value yielded the highest diagnostic accuracy for FS, with a sensitivity and specificity of 73.2% and 77.5%, respectively. The area under the curve for IJC thickness was 0.824 (95% confidence interval, 0.76–0.89). US measurement of the IJC in the neutral position yielded good diagnostic accuracy for FS. Because IJC thickness is affected by arm rotation, it is important to measure the IJC thickness in a standardized posture to ensure diagnostic value.

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