Role of Ultrasonography in Diagnosis and Treatment of Frozen Shoulder

ABSTRACT

Frozen shoulder (FS) is a common, painful and disabling condition of the shoulder. Patients usually present with an insidious onset of symptoms with gradual restriction and loss of shoulder mobility. FS can be categorized into primary and secondary types. The natural course of FS is characterized by the following 3 stages the painful, the freezing/frozen, and the thawing phase based on the duration of symptoms, as well as pain and limitation of motion observed on physical examination. Diagnosis of FS is based on careful and accurate history taking and physical examination. Imaging modalities including arthrography, ultrasonography, and magnetic resonance imaging are useful in excluding concomitant painful conditions of the shoulder and in confirming FS. Ultrasonography is recommended as the first-line imaging modality to diagnose FS because it is noninvasive, it provides an easy comparison of ultrasonography parameters between the affected and unaffected sides, and it reflects the clinical characteristics of FS. The goal of treatment in patients with FS is pain reduction and restoration of normal function and mobility of the shoulder. Ultrasonography-guided glenohumeral joint injection, suprascapular nerve block, and distention arthrography achieve favorable therapeutic outcomes by virtue of greater accuracy. Ultrasonography and ultrasonography guided injections can accurately diagnose and effectively treat patients with FS.