Frozen Shoulder: Current Concept of Management

BACKGROUND: Frozen shoulder is a musculoskeletal disorder resulting from chronic inflammation of the capsule subsynovial layer and characterized with capsular thickening, progressive fibrosis, and contracture of the glenohumeral joint capsule. This condition is a relatively common condition that mimics other condition and its management requires deliberate consideration of patient’s condition. REVIEW ARTICLE: This article reviews and summarize latest findings of frozen shoulder. The diagnosis of frozen shoulder is described from the patient history, physical examination in look, feel, and move sequence to the supporting examinations. The current evidence of managements of frozen shoulder is described, from the nonoperative to the surgical approach. CONCLUSION: Most of frozen shoulder cases resolve spontaneously thus conservative treatment should be the first choice of frozen shoulder. However, for cases that failed with conservative treatment and had a debilitating effect to patient’s daily life or cases with history of surgery, operative treatment should be considered. Operative treatment is aimed to release the capsule either by manipulation under anesthesia, by arthroscopy, or by open surgery. Physical rehabilitation following every procedure is mandatory and key to maintain range of motion years following the surgery.

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Ruptures of the Plantar Fascia: A Systematic Review of the Literature

Foot & Ankle Specialist ◽

10.1177/1938640020974889 ◽

2020 ◽

pp. 193864002097488

Author(s):

Massimiliano Mosca ◽

Mario Fuiano ◽

Simone Massimi ◽

Davide Censoni ◽

Giuseppe Catanese ◽

...

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Operative Treatment ◽

Cochrane Review ◽

Rare Condition ◽

Plantar Fascia ◽

Asymptomatic Patients ◽

Incidence Risk ◽

Local Injections ◽

History Of

Introduction Rupture of the plantar fascia is a rare condition. It can also occur spontaneously and with no history of disease of the plantar fascia, above all in athletes. This review aims to systematically analyze all cases described in the literature regarding the rupture of the plantar fascia, evaluating incidence, risk factors, and treatments, considering which procedures show the best outcomes and the highest success rate. Materials and methods A systematic review of PubMed, Google Scholar, and Cochrane review computerized databases was performed, focusing on articles about cases of rupture of the plantar fascia; 18 studies fulfilled all the criteria and were analyzed. There were no randomized controlled trials. Results A total of 155 patients (157 foot) were included in this systematic review. Considering all the studies included, 12 patients had a spontaneous rupture, 138 patients had a diagnosis of plantar fasciitis, and 130 patients were treated with local injections of corticosteroid before the rupture. Only 2 cases of bilateral rupture were reported. In all, 15 studies reported conservative treatment, with a total of 154 patients (156 feet) included. Operative treatment was reported in 3 studies, with 3 patients (3 feet) treated. Conclusions Ruptures of the plantar fascia are very rare in asymptomatic patients and more common in patients treated with injection of steroids in the plantar fascia. Conservative treatment, although not standardized in the literature, led to good outcomes in most cases. Chronic ruptures of the fascia should be considered for operative treatment. Levels of Evidence: Level III

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Is the Frozen Shoulder Classification a Reliable Assessment?

Clinics in Shoulder and Elbow ◽

10.5397/cise.2018.21.2.82 ◽

2018 ◽

Vol 21 (2) ◽

pp. 82-86 ◽

Cited By ~ 1

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.

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Surgery for cervical dystonia: the emergence of denervation and myotomy techniques and the contributions of early surgeons at The Johns Hopkins Hospital

Journal of Neurosurgery Spine ◽

10.3171/2009.9.spine09276 ◽

2010 ◽

Vol 12 (3) ◽

pp. 280-285 ◽

Cited By ~ 2

Author(s):

Todd D. Vogel ◽

Courtney Pendleton ◽

Alfredo Quinoñes-Hinojosa ◽

Aaron A. Cohen-Gadol

Keyword(s):

Operative Treatment ◽

Cervical Dystonia ◽

Early History ◽

Surgical Approaches ◽

Johns Hopkins Hospital ◽

Surgical Patient ◽

History Of Surgery ◽

New Techniques ◽

History Of ◽

Posterior Neck

Cervical dystonia is a psychologically and physically disabling disease that has intrigued clinicians since the early history of surgery. Because of its elusive etiology, its operative treatment has had an extended evolutionary voyage. Early surgical approaches involved resection of the sternocleidomastoid muscle. Later recognition of more diffuse involvement of the posterior neck muscles led to the introduction of new techniques with more effective results. A review of available surgical patient records at The Johns Hopkins Hospital from around the turn of the 20th century provided a glimpse of the early history of the operative treatment for torticollis through the work of some of the leaders of surgery, including Halsted, Cushing, and specifically Finney. Here, the authors present a segment of history on the surgical treatment of this disease as it relates to the introduction of myotomy and denervation techniques.

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Frozen shoulder: overview of clinical presentation and review of the current evidence base for management strategies

Future Science OA ◽

10.2144/fsoa-2020-0145 ◽

2020 ◽

Vol 6 (10) ◽

pp. FSO647

Author(s):

Akshay Date ◽

Luthfur Rahman

Keyword(s):

Clinical Presentation ◽

Glenohumeral Joint ◽

Adhesive Capsulitis ◽

Management Strategies ◽

Frozen Shoulder ◽

Scar Tissue ◽

Evidence Base ◽

Current Evidence ◽

Economic Implications ◽

Current Evidence Base

Adhesive capsulitis of the shoulder (ACS) is a condition with significant clinical and economic implications. The etiology of adhesive capsulitis is not clearly understood and there remains lack of consensus in clinical management for this condition. It can occur as a primary idiopathic condition or secondary to medical conditions or trauma. The hallmarks of ACS are pain and stiffness, caused by formation of adhesive or scar tissue in the glenohumeral joint. Management strategies vary depending on stage of presentation, patient factors and clinician preferences, and can range from conservative options to surgical intervention. The aim of this review is to summarize the pathophysiology and clinical presentation of ACS and to discuss the evidence base for various management strategies employed today.

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Comparison of Clinical Outcomes between Idiopathic Frozen Shoulder and Diabetic Frozen Shoulder After a Single Ultrasound-Guided Intra-Articular Corticosteroid Injection

Diagnostics ◽

10.3390/diagnostics10060370 ◽

2020 ◽

Vol 10 (6) ◽

pp. 370

Author(s):

Chul-Hyun Cho ◽

Hyo-Joon Jin ◽

Du Hwan Kim

Keyword(s):

Conservative Treatment ◽

Range Of Motion ◽

Clinical Outcomes ◽

Glenohumeral Joint ◽

Steroid Injection ◽

Corticosteroid Injection ◽

Frozen Shoulder ◽

Ultrasound Guided ◽

Analog Scale ◽

Corticosteroid Injections

There is no consensus on the use of intra-articular corticosteroid injections in diabetic frozen shoulder (FS). Thus, we aimed to compare clinical outcomes after intra-articular corticosteroid injections in patients with diabetic FS and idiopathic FS. Data collected from 142 FS patients who received glenohumeral joint intra-articular corticosteroid injections were retrospectively reviewed. Thirty-two patients were diagnosed with diabetic FS and 110 patients with idiopathic FS. Data including visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), and passive range of motion (ROM) were compared before the injection and at 3, 6, and 12 weeks after the injection. There were significant improvements in all outcomes (p < 0.001 for all parameters) through 12 weeks in both groups. There were no significant differences in all outcomes, except for ASES scores, between both groups at 3 weeks. However, there were significant differences in VAS score, SSVs, ASES scores, and passive ROMs, except for angle of abduction, between the two groups at 6 weeks and 12 weeks after injection. A single intra-articular steroid injection can be used as a conservative treatment for diabetic FS, but less effective than for idiopathic FS.

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The Tempo and mode(S) of Prebiotic Evolution

International Astronomical Union Colloquium ◽

10.1017/s0252921100014937 ◽

1997 ◽

Vol 161 ◽

pp. 419-429 ◽

Cited By ~ 1

Author(s):

Antonio Lazcano

Keyword(s):

Origin Of Life ◽

Organic Compounds ◽

Biological Evolution ◽

Current Evidence ◽

Early Diversification ◽

Time Period ◽

The Galaxy ◽

History Of ◽

Widespread Phenomenon ◽

The Origin Of Life

AbstractDifferent current ideas on the origin of life are critically examined. Comparison of the now fashionable FeS/H2S pyrite-based autotrophic theory of the origin of life with the heterotrophic viewpoint suggest that the later is still the most fertile explanation for the emergence of life. However, the theory of chemical evolution and heterotrophic origins of life requires major updating, which should include the abandonment of the idea that the appearance of life was a slow process involving billions of years. Stability of organic compounds and the genetics of bacteria suggest that the origin and early diversification of life took place in a time period of the order of 10 million years. Current evidence suggest that the abiotic synthesis of organic compounds may be a widespread phenomenon in the Galaxy and may have a deterministic nature. However, the history of the biosphere does not exhibits any obvious trend towards greater complexity or «higher» forms of life. Therefore, the role of contingency in biological evolution should not be understimated in the discussions of the possibilities of life in the Universe.

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History of surgery for endometriosis and Assisted-Reproductive Technology outcomes in women with deep infiltrating endometriosis

10.26226/morressier.5912d9e9d462b80292386e2f ◽

2017 ◽

Author(s):

Chloé Maignien

Keyword(s):

Assisted Reproductive Technology ◽

Reproductive Technology ◽

Deep Infiltrating Endometriosis ◽

History Of Surgery ◽

History Of ◽

Infiltrating Endometriosis

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Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126606 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6606

Author(s):

Jolanta Nawrocka-Rutkowska ◽

Iwona Szydłowska ◽

Aleksandra Rył ◽

Sylwester Ciećwież ◽

Magdalena Ptak ◽

...

Keyword(s):

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Pelvic Pain ◽

Predictive Value ◽

Chronic Pelvic Pain ◽

Reproductive Age ◽

Pelvic Surgery ◽

History Of Surgery ◽

Previous Surgery ◽

History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

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