Considerations about a unique clinical pattern: flexion block of the shoulder.
Frozen shoulder is a well-defined nosologic entity characterized by retraction of the anterior portion of the glenohumeral joint capsule. When clinical findings are inconclusive, arthrography can differentiate a frozen shoulder from a stiff and painful shoulder. We report three cases of stiffness of the shoulder that we believe was due to a unique pathological process. Flexion was restricted to 120 degrees and a sensation suggestive of mechanical blockage was felt upon passive flexion. Medical rotation was restricted and painful, whereas lateral rotation with the elbow held against the torso was normal. Findings upon arthrography or magnetic resonance imaging were normal, with no evidence of capsulitis or chronic rotator cuff lesions. Our pathogenic hypotheses include a lesion of the proximal portion of the long head of the biceps brachii or a focal ligamentous lesion. Treatment should consist of specific physical therapy and, in refractory forms, gentle mobilization under general anesthesia.
Thomas
T
T
Department of Rheumatology, Bellevue Hospital, France.
Gazielly
D
D
Bruyère
G
G
Alexandre
C
C
D000328:Adult; D001175:Arthrography; D002062:Bursitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000000981:diagnostic imaging