SciELO - Scientific Electronic Library Online

vol.7 issue4Part I: Metabolic bone disease: Histomorphometry as a diagnostic aidBifacet dislocations of cervical spine: Acute management and outcome author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand



Related links

  • On index processCited by Google
  • On index processSimilars in Google


SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X

SA orthop. j. vol.7 n.4 Centurion Oct./Dec. 2008




Accessory features of frozen shoulder



JF de BeerI; F LamII

IMBChB, MMed(Orth). Orthopaedic Surgeon, Cape Shoulder Institute, Plattekloof, Panorama, Cape Town, South Africa
IIMBBS MRCS(Glasg), MRCS (Ed), MSc (Orth Engineering), FRCS Ed (Tr & Orth). Consultant Orthopaedic Surgeon, Hillingdon Hospital NHS Trust, Pield Heath Road, Hillingdon, Uxbridge, UB8 3NN





We have described nine clinical features to aid the clinical diagnosis of frozen shoulder. These include symptoms of pain and pins-and-needles radiating down the arm to the hand, feeling of lameness in the arm, tenderness over the medial border of scapula, rotator interval and supraclavicular fossa, reduction of pain with passive abduction and forward flexion of the shoulder, asymmetry of the arm position at rest with an increase in elbow-to-waist distance and apparent winging of the scapula. In this prospective study, we report the sensitivity, specificity, predictive values and diagnostic accuracy of each clinical test and discuss their probable causes and clinical relevance. The single most accurate diagnostic test was relief of symptoms with abduction and flexion. In the diagnosis of a patient with a painful stiff shoulder, if six of the accessory features with the highest correlation are present, the probability of having frozen shoulder is 80%.



“Full text available only in PDF format”




1. Codman EA. The Shoulder. Boston: Todd. 1934:216-24.         [ Links ]

2. Duplay ES: De la periarthrite scapulo-humerale. Rev Frat Trav Med 1896;53:226.         [ Links ]

3. Quigley TB. Checkrein shoulder; a type of frozen shoulder; diagnosis and treatment by manipulation and ACTH or cortisone. N Engl J Med 1954 Feb 4;250(5):188-92.         [ Links ]

4. Neviaser JS. Adhesive capsulitis of the shoulder. J Bone Joint Surg Am 1945;27:211-22.         [ Links ]

5. Bunker TD. Time for a new name for 'frozen shoulder'. Br Med J (Clin Res Ed) 1985 April 27;290(6477):1233-4.         [ Links ]

6. Malhi AM, Khan R. Correlation between clinical diagnosis and arthroscopic findings of the shoulder. Postgrad Med J 2005 Oct;81(960):657-9.         [ Links ]

7. Kuhn JE, Plancher KD, Hawkins RJ. Scapular winging. J Am Acad Orthop Surg 1995;3:319-25.         [ Links ]

8. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg 2003;11:142-51.         [ Links ]

9. Warner JJP, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome. Clinical Orthopaedics and Related Research 1992;285:191-9.         [ Links ]

10. Paletta GA, Warner JJP, Warren RF, Deutsch A, Altchek DW. Shoulder kinematics with two-plane X-ray evaluation in patients with anterior instability or rotator cuff tearing. J Shoulder Elbow Surg 1997;6:516-27.         [ Links ]

11. Clare DJ, Wirth MA, Groh GI et al. Current concepts review: shoulder arthrodesis. J Bone Joint Surg 2001;83:593-600.         [ Links ]

12. Groh GI, Williams GR, Jarman RN, Rockwood CA. Treatment of complications of shoulder arthrodesis. J Bone Joint Surg 1997;79:881-7.         [ Links ]

13. Omari A, Bunker TD. Open surgical release for frozen shoulder: surgical findings and results of the release. J Shoulder Elbow Surg 2001;10:353-7.         [ Links ]

14. Neer CS II, Satarlee CC, Dalsey RM, Flatow EL. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop 1992;280:182-5.         [ Links ]

15. Wiley AM. Arthroscopic appearance of frozen shoulder. Arthroscopy 1991;7:138-43.         [ Links ]

16. Plancher KD, Johnston JC, Peterson RK, Hawkins RJ. The dimensions of the rotator interval. J Shoulder Elbow Surg 2005;14:620-5.         [ Links ]



Reprint requests:
Dr J de Beer
PO Box 15741, Panorama 7506. Western Cape



This article was not submitted to an ethical committee for approval. The content of this article is the sole work of the authors. No benefits of any form have been derived from any commercial party related directly or indirectly to the subject of this article.

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License