Frozen shoulder: exploration of terminology and classification DOI Creative Commons
Fabrizio Brindisino, Elif Turgut, Filip Struyf

et al.

Frontiers in Rehabilitation Sciences, Journal Year: 2024, Volume and Issue: 5

Published: Nov. 25, 2024

Frozen Shoulder (FS) is a condition characterized by inflammation of the glenohumeral joint capsule, leading to fibrosis and resulting in functional disability reduced quality life [1,2]. Specific landmarks for diagnosis include ROM restriction at least 25% two movement planes, with more than 50% limitation external rotation arm side compared unaffected side. Additionally, symptoms must be stable one month or worsening [3]. This estimated affect up 10% general population, higher incidence subjects aged 40-60 years [4].FS has been described using various terms classifications medical literature [5].Historically, broad labels like 'humeroscapular periarthritis' were used, reflecting limited understanding its causes. Terms such as adhesive capsulitis, periarthritis, shoulder contracture are often used interchangeably, highlighting uncertainties about FS pathophysiology ongoing debates on whether it should classified etiology, severity, other criteria.Inconsistent terminology heterogeneous samples can limit research efforts, making challenging pool data across studies compare treatment outcomes confidence targeting specific patient group.In this opinion paper, we reviewed scientific classificationhighlighting need unified improve communication among researchers clinicians. proposed new perspectives relationship between concurrent conditions FS.Naming. Over 15 different have identify FS, 'frozen shoulder,' 'shoulder stiffness,' 'adhesive capsulitis' being most common [5].The term stiffness' misleading, describes clinical phenotype that may result from -e.g., osteoarthritis, calcific tendinopathy, muscular contracture. Furthermore, no history leads 'stiff shoulder' nor there an established threshold define 'stiff.' Therefore, while all cases exhibit stiffness, not instances stiffness qualify FS.The aims describe underlying pathological process condition, but proves inaccurate, adhesions consistently observed [5]. 'capsulitis' implies persistent inflammatory process, which typically only present onset disease [3,6]. misleading detrimental-as promote inappropriate treatments, adhesion detachment. Notably, international societies, ISAKOS (International Society Arthroscopy, Knee Surgery, Orthopaedic Sports Medicine) [7] ASES (American Elbow Surgeons) [8] advised against term; therefore recommend discarding well. Some argue 'FS' mainly later stages accurately reflects patient's experience -a gradually 'freezes', becomes immobile, then 'thaws', partial recovery motion. By implying generally favorable prognosis, also compliance adherence treatment. sense, frozen tissue cause pain allodynia [9], potentially explaining constant, stabbing patients experience, especially early on. However, does encompass initial phase precedes fibrosis. To date, clear consensus ideal capture etiopathogenesis, presentation, perspective condition. suggest 'Frozen Shoulder' precise term, remains suitable, widely accepted supported societies.Classification. The further categorizes into primary (without identifiable cause) secondary (with hypothesized cause), intra-articular factors -e.g. chondral lesions, labral tears, synovitis, tendonitis rotator cuff biceps-as well extra-articular ipsilateral breast surgery, cervical radiculopathy, chest wall tumors, fractures humeral shaft clavicle- [7,8]. classification based anatomical structures involved rather presence plausible conceivable [7,8].In authors' opinion, prior -as mentioned above-followed development necessarily indicate causal relationship. Instead, viewed chronological association, current evidence suggesting possible connection definitive cause. could occur independently coexisting pathology, precede [10] serve warning sign [11,12]. appropriate refer 'weak/strong predisposing factors' causative ones.Although empirical observations proof still needed. We 'hypothesized' 'related' 'associated,' these imply priori certainty correlation do yet have.The Upper Extremity Council recommends reserving 'primary stiffness', 'secondary find distinction unhelpful, reduces inter-rater diagnostic agreement [13], adds little diagnosis, management, prognosis. confuse clinicians, them believe fundamentally despite similar presentations treatments. create approach -and avoid 'Babylonian confusion 'languages' [14] offering benefit patients-we sole label, possibly specifying any hypothetically related pathologies. extrinsic/intrinsic subtype 'secondary' [8]: 'intrinsic' referring within joint, disorders, biceps tendinitis, [7]. In contrast, 'extrinsic' subtypes developing linked located outside tumor, cerebrovascular accident-or local extrinsic issues -including previous fracture, acromioclavicular arthritis, clavicle fracture our sub-classification both useful convincing, comorbidities 85% -with 37.5% having three [6]. serves reminder clinicians consider pathologies when treating warrant pharmacological, surgical, therapeutic interventions [15], particularly multidisciplinary expertise required. precautions needed certain comorbidities, recently stabilized repaired tendons [16].Another four-arm 'FS cause' was -comprising intra-articular, capsular, extra-articular, neurologic causes align abovementioned broader categories, preferable improving classification. Moreover, systems provided systemic sub-categorization associated disorders-e.g. diabetes mellitus hyper/hypothyroidism [8]. achieved some Korean surgeons [13] omitted paper systemic/metabolic status considered distinct category per se.Accordingly, -such metabolic system involvement [17], blood glucose availability [12], dysautonomia [18,19], low psychological mood [20], altered lipid metabolism [21,22], sedentary lifestyle [6]-may predispose individuals FS. These contribute 'low-grade status', forming environment progression influence prognosis [6,18,23].Overall, remain varied, challenges arising variations descriptions nomenclature, suitable label. lack extends distinctions intrinsic subtypes, associations-complicating strategies.Discussion. authors approved societies. For classification, propose simplified approach, label treatment, (Figure 1). It essential recognize 'hypothetically pathology' pose life-threatening risks. underscores necessity fostering collaboration ensure optimal care. advocate continuous monitoring patients' histories tracking changes throughout their important simultaneously, underscoring thorough management. Ultimately, crucial community continue refining emerging shared understanding.FS, ROM, Range Movement ISAKOS, International Surgery Medicine ASES, American Surgeons

Language: Английский

Classification of shoulder diseases in older adult patients: a narrative review DOI Creative Commons
Hyo-jin Lee, Jong-Ho Kim

The Ewha Medical Journal, Journal Year: 2025, Volume and Issue: 48(1)

Published: Jan. 31, 2025

This review classifies and summarizes the major shoulder diseases affecting older adults, focusing on rotator cuff disease, frozen shoulder, osteoarthritis, instability. It explores each condition's pathophysiology, risk factors, clinical presentation, diagnostic approaches, treatment strategies to guide clinicians in optimizing patient outcomes enhancing quality of life. Age-related degenerative changes, comorbidities, distinct etiological factors contribute presentation disorders adults. Rotator disease ranges from tendinopathy full-thickness tears is influenced by genetic predispositions, inflammatory cytokines, muscle quality. Frozen results fibroproliferative changes capsule, leading significant pain restricted motion. Osteoarthritis involves cartilage degeneration bony remodeling, often necessitating surgical interventions such as arthroplasty. Shoulder instability, though less frequent, complicated associated injuries like fractures, requiring tailored management strategies. Advances imaging techniques, biologic treatments, procedures, particularly arthroscopic arthroplasty options, have improved accuracy therapeutic outcomes. A thorough classification adult patients highlights complexity managing these conditions. Effective requires individualized approaches that integrate conservative measures with emerging or therapies. Future research should focus targeted interventions, standardized criteria, multidisciplinary collaboration minimize disability, optimize function, improve overall life this growing population. Multimodal strategies, including education, structured rehabilitation, psychosocial support, further enhance long-term adherence Ongoing vigilance for osteoporosis metabolic disorders, necessary comprehensive care.

Language: Английский

Citations

1
Shoulder pain among type 2 diabetes mellitus patients: A cross-sectional study in Chilean population DOI
Fernanda Assis Paes Habechian,

Mauricio Esteban Flores-Quezada,

Antonio Martínez-Ortega

et al.

Primary care diabetes, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

0
Frozen shoulder: exploration of terminology and classification DOI Creative Commons
Fabrizio Brindisino, Elif Turgut, Filip Struyf

et al.

Frontiers in Rehabilitation Sciences, Journal Year: 2024, Volume and Issue: 5

Published: Nov. 25, 2024

Frozen Shoulder (FS) is a condition characterized by inflammation of the glenohumeral joint capsule, leading to fibrosis and resulting in functional disability reduced quality life [1,2]. Specific landmarks for diagnosis include ROM restriction at least 25% two movement planes, with more than 50% limitation external rotation arm side compared unaffected side. Additionally, symptoms must be stable one month or worsening [3]. This estimated affect up 10% general population, higher incidence subjects aged 40-60 years [4].FS has been described using various terms classifications medical literature [5].Historically, broad labels like 'humeroscapular periarthritis' were used, reflecting limited understanding its causes. Terms such as adhesive capsulitis, periarthritis, shoulder contracture are often used interchangeably, highlighting uncertainties about FS pathophysiology ongoing debates on whether it should classified etiology, severity, other criteria.Inconsistent terminology heterogeneous samples can limit research efforts, making challenging pool data across studies compare treatment outcomes confidence targeting specific patient group.In this opinion paper, we reviewed scientific classificationhighlighting need unified improve communication among researchers clinicians. proposed new perspectives relationship between concurrent conditions FS.Naming. Over 15 different have identify FS, 'frozen shoulder,' 'shoulder stiffness,' 'adhesive capsulitis' being most common [5].The term stiffness' misleading, describes clinical phenotype that may result from -e.g., osteoarthritis, calcific tendinopathy, muscular contracture. Furthermore, no history leads 'stiff shoulder' nor there an established threshold define 'stiff.' Therefore, while all cases exhibit stiffness, not instances stiffness qualify FS.The aims describe underlying pathological process condition, but proves inaccurate, adhesions consistently observed [5]. 'capsulitis' implies persistent inflammatory process, which typically only present onset disease [3,6]. misleading detrimental-as promote inappropriate treatments, adhesion detachment. Notably, international societies, ISAKOS (International Society Arthroscopy, Knee Surgery, Orthopaedic Sports Medicine) [7] ASES (American Elbow Surgeons) [8] advised against term; therefore recommend discarding well. Some argue 'FS' mainly later stages accurately reflects patient's experience -a gradually 'freezes', becomes immobile, then 'thaws', partial recovery motion. By implying generally favorable prognosis, also compliance adherence treatment. sense, frozen tissue cause pain allodynia [9], potentially explaining constant, stabbing patients experience, especially early on. However, does encompass initial phase precedes fibrosis. To date, clear consensus ideal capture etiopathogenesis, presentation, perspective condition. suggest 'Frozen Shoulder' precise term, remains suitable, widely accepted supported societies.Classification. The further categorizes into primary (without identifiable cause) secondary (with hypothesized cause), intra-articular factors -e.g. chondral lesions, labral tears, synovitis, tendonitis rotator cuff biceps-as well extra-articular ipsilateral breast surgery, cervical radiculopathy, chest wall tumors, fractures humeral shaft clavicle- [7,8]. classification based anatomical structures involved rather presence plausible conceivable [7,8].In authors' opinion, prior -as mentioned above-followed development necessarily indicate causal relationship. Instead, viewed chronological association, current evidence suggesting possible connection definitive cause. could occur independently coexisting pathology, precede [10] serve warning sign [11,12]. appropriate refer 'weak/strong predisposing factors' causative ones.Although empirical observations proof still needed. We 'hypothesized' 'related' 'associated,' these imply priori certainty correlation do yet have.The Upper Extremity Council recommends reserving 'primary stiffness', 'secondary find distinction unhelpful, reduces inter-rater diagnostic agreement [13], adds little diagnosis, management, prognosis. confuse clinicians, them believe fundamentally despite similar presentations treatments. create approach -and avoid 'Babylonian confusion 'languages' [14] offering benefit patients-we sole label, possibly specifying any hypothetically related pathologies. extrinsic/intrinsic subtype 'secondary' [8]: 'intrinsic' referring within joint, disorders, biceps tendinitis, [7]. In contrast, 'extrinsic' subtypes developing linked located outside tumor, cerebrovascular accident-or local extrinsic issues -including previous fracture, acromioclavicular arthritis, clavicle fracture our sub-classification both useful convincing, comorbidities 85% -with 37.5% having three [6]. serves reminder clinicians consider pathologies when treating warrant pharmacological, surgical, therapeutic interventions [15], particularly multidisciplinary expertise required. precautions needed certain comorbidities, recently stabilized repaired tendons [16].Another four-arm 'FS cause' was -comprising intra-articular, capsular, extra-articular, neurologic causes align abovementioned broader categories, preferable improving classification. Moreover, systems provided systemic sub-categorization associated disorders-e.g. diabetes mellitus hyper/hypothyroidism [8]. achieved some Korean surgeons [13] omitted paper systemic/metabolic status considered distinct category per se.Accordingly, -such metabolic system involvement [17], blood glucose availability [12], dysautonomia [18,19], low psychological mood [20], altered lipid metabolism [21,22], sedentary lifestyle [6]-may predispose individuals FS. These contribute 'low-grade status', forming environment progression influence prognosis [6,18,23].Overall, remain varied, challenges arising variations descriptions nomenclature, suitable label. lack extends distinctions intrinsic subtypes, associations-complicating strategies.Discussion. authors approved societies. For classification, propose simplified approach, label treatment, (Figure 1). It essential recognize 'hypothetically pathology' pose life-threatening risks. underscores necessity fostering collaboration ensure optimal care. advocate continuous monitoring patients' histories tracking changes throughout their important simultaneously, underscoring thorough management. Ultimately, crucial community continue refining emerging shared understanding.FS, ROM, Range Movement ISAKOS, International Surgery Medicine ASES, American Surgeons

Language: Английский

Citations

1