How is frozen shoulder diagnosed?
The diagnosis of frozen shoulder is made only after
a careful history and physical examination is performed. Pain and
loss of motion can be symptoms of many shoulder conditions, so a
detailed assessment of the shoulder's full range of motion is important.
A history of surgery or injury, or the presence of illnesses such
as diabetes, is information the physician needs in order to make
the correct diagnosis.
It is important to recognize the different patterns of motion loss.
Primary adhesive capsulitis is usually associated with loss of motion
in all directions. Secondary adhesive capsulitis more often has
more defined loss of motion; affecting some movements, but not others.
In most cases, the history and examination are sufficient to determine
the presence or absence of frozen shoulder. Imaging may occasionally
be necessary to confirm the diagnosis and to identify other underlying
- X-rays cannot reveal the
cause of shoulder stiffness in most cases of primary adhesive
capsulitis. However, in secondary adhesive capsulitis, X-rays
can show signs of arthritis, fractures, or metallic plates that
may be contributing to motion loss.
- An MRI (Magnetic Resonance Image)
shows soft tissue and may be used in cases in which another disorder
is suspected, such as a rotator cuff tear.
- An arthrogram may be used
with an MRI to provide further information about structures in
the shoulder. A dye is injected into the shoulder and images are
obtained. The dye creates a contrast on the image, making the
specific location of adhesions and the reduced space typical of
frozen shoulder more visible.