Frozen Shoulder

This is common terminology used to explain the symptom of pain in the shoulder when there is limitation of movements although the underlying pathology can quite diverse.

The commonest cause for frozen shouder is adhesive capsulitis. However in my experience I have seen various shoulder pathologies clinically diagnosed as frozen shoulder, the commonest being rotator cuff tear, tendinitis and subacromial bursitis.

Hence ultrasound of the shoulder is a good start to make a difinite diagnosis prior to any treatment or intervention.

This 65 year-old was diagnosed to have frozen shoulder and was referred for an ultrasound after physiotherapy and no improvement in pain for 8 months. The ultrasound examination showed a 1cm full thickness tear of the supraspinatus tendon and the adjacent bone showed cortical irregularity suggesting underlying osteophyte and osteoarthritic change which had probably caused the tear.

There was no associated adhesive capsulitis and the patient had limited range of movements. We then arranged for an MRI scan and referred the patient to a shoulder surgeon for assessment and treatement..