With the advent of an aging population, shoulder pain is becoming more and more common. People think they have “frozen shoulder” when they have shoulder pain, stiffness and can’t lift their shoulders, and even some orthopedic surgeons often use the term “frozen shoulder” to diagnose shoulder pain in a general way. In fact, shoulder pain is not equal to “frozen shoulder” at all, and “frozen shoulder” is no longer a standardized and accurate diagnostic term. A typical misdiagnosis case 74-year-old Ms. Xiao complained of shoulder pain for 2 years, waking up at night with pain, which seriously affected her sleep. The pain is recurrent and has worsened after a fall in the last three months, making it difficult to dress and bathe and affecting daily life. I have been to many hospitals, but I have been treated as “frozen shoulder”. I have taken western medicine, Chinese medicine, physiotherapy, massage, acupuncture, and even had closed-loop treatment, and I have also followed medical advice to exercise, climb walls, and hoop activities. Despite various conservative treatments, he did not see any improvement and the shoulder pain continued to exist as it worsened after each exercise. After careful examination by Dr. Yang Rui at the Sun Yat Sen Memorial Hospital of Sun Yat-sen University, she was diagnosed with “rotator cuff injury” instead of the so-called “frozen shoulder”; the MRI showed “rotator cuff injury with significant supraspinatus tendon tear”. The MRI showed “rotator cuff injury with significant supraspinatus tendon tear”, which confirmed the doctor’s judgment. Later, after minimally invasive shoulder arthroscopy, the treatment was very effective and the pain was relieved. There are many patients like Ms. Xiao who had rotator cuff injury mistaken for “frozen shoulder” in our shoulder specialist clinic. The misdiagnosis and delay in treatment may cause irreversible consequences such as muscle atrophy, muscle fat infiltration and serious degeneration of joint cartilage. The origin of “frozen shoulder” Frozen shoulder is a diagnostic term that encompasses all painful diseases around the shoulder joint, but in fact it only refers to one disease in particular (discussed below). The literal meaning of periarthritis is general and ambiguous, which can lead to misdiagnosis of shoulder pain. The term has a long history, as it was first described systematically by the French surgeon Duplay in 1872.
The first systematic description of the disease was given by the French surgeon Duplay in 1872, using the French term “Periarthritescapulohumérale”, which is the earliest origin of the term periarthritis, so it was also called “Duplay ‘s
disease”; in 1882 Putnam applied the English term “Periarthritis of the shoulder”, thus the term “periarthritis” was used.
In 1882, Putnam used the English term “Periarthritis of shoulder”, so it is clear that “frozen shoulder” is an authentic foreign term, not a traditional Chinese medical term (Chinese medicine calls it periarthritis of the scapula, or shoulder fungus), and I really don’t understand why Chinese doctors nowadays prefer to use the foreign term “frozen shoulder”. The term “frozen shoulder” was first used by Codman in 1934 to diagnose unexplained shoulder pain and progressive stiffness; in 1945[4] Nevasier applied the term “adhesive capsulitis” to name this condition. ” to name this disease. In the last 20 years, we found that the term “frozen shoulder” is still widely used only in Chinese literature, while foreign literature mostly uses the term Frozen
Shoulder (frozen shoulder) or Adhesive
capsulitis (adhesive capsulitis), with frozen shoulder being the most widely used in the specialized field of shoulder joint. It seems that we should also abandon the familiar term “frozen shoulder” and adopt a more accurate expression, “frozen shoulder”, in order to give the patient an accurate diagnosis before we can talk about the next formal treatment. C. What is frozen shoulder? The incidence of primary frozen shoulder is about 2% to 5%, and it is more common in women than in men. The peak period is about 4 months after the onset of the disease, and some patients can recover completely in about 1 year after the onset of remission in 6 months. As you can see, frozen shoulder can be equated with primary frozen shoulder, and the latter is a more accurate diagnosis based on the characteristics of the disease. Fourth, what is the majority of shoulder pain? With the development of shoulder surgery, especially the improvement and popularization of shoulder specialist examination techniques, combined with the clinical application of MRI and CT, specialists have realized that there are many diseases that cause shoulder pain, including rotator cuff injury, acromioclavicular impingement, rostral impingement, frozen shoulder (shoulder adhesive capsulitis), SLAP injury, shoulder instability, recurrent shoulder dislocation, tendinopathy, glenoid labral injury , glenoid cyst, calcific supraspinatus tendinitis, acromioclavicular joint disease, shoulder osteoarthritis, thoracic outlet syndrome, and suprascapular nerve entrapment syndrome. A statistical study found that the incidence of rotator cuff injury and acromioclavicular impingement was the highest among elderly people over 60 years old who visited the doctor for shoulder pain, reaching 85%, and its incidence was much higher than that of the so-called “frozen shoulder” (primary frozen shoulder). Fifth, shoulder pain should not be diagnosed as frozen shoulder because the differential diagnosis of shoulder pain is inherently difficult and doctors without specialized training in shoulder surgery lack diagnostic experience. The term “frozen shoulder” is a general and ambiguous diagnosis, which also leads to a lot of underdiagnosis, misdiagnosis and misdiagnosis, for example, some functional exercises of “acromioclavicular impingement” and “frozen shoulder” are opposite. For example, some of the functional exercises for “frozen shoulder” and “shoulder impingement” are opposite, and if you follow the exercise of “pulling rings, climbing high, and throwing arms” as in the case of frozen shoulder, it may lead to serious consequences of rotator cuff tears. “Frozen shoulder” is a good diagnosis, but because it has so many disadvantages, it is not used by the general public, so we recommend that specialists do not use it.