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Differential diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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These include:

  • tears or tendinitis of the rotator cuff e.g. supraspinatus tendinitis or the painful arc syndrome - pain present in a small arc of movement, and only during active movement and, unlike frozen shoulder, the range of passive movements is generally normal
  • stiffness following shoulder injury - stiffness is greatest immediately after the injury and then declines. In a frozen shoulder, stiffness gradually increases after the injury over a period of several months
  • stiffness from disuse - a shoulder which is not used will gradually become stiff, for example, a broken forearm which is nursed overcautiously. However, the pattern of stiffness differs from that of a frozen shoulder
  • reflex sympathetic dystrophy - shoulder pain and stiffness may follow a stroke or myocardial infarction. A mild reflex sympathetic dystrophy may quite closely resemble a frozen shoulder, but severe forms of the disease also induce trophic and vasomotor changes in the hand
  • arthritis of the shoulder joint
  • polymyalgia rheumatica - especially if both shoulders are affected
  • infective arthritis in an immunosuppressed patient
  • polymyositis
  • Pancoast's syndrome
  • a posterior dislocation of the glenohumeral joint that has become locked
  • early Parkinson's disease (1)

Reference:

  1. Drug and Therapeutics Bulletin 2000; 38 (11): 86-88.

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