School of Infection and Immunity, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Department of Trauma and Orthopaedics, West Hertfordshire Hospital Trust, Watford, UK.
Nat Rev Dis Primers. 2022 Sep 8;8(1):59. doi: 10.1038/s41572-022-00386-2.
Frozen shoulder is a common debilitating disorder characterized by shoulder pain and progressive loss of shoulder movement. Frozen shoulder is frequently associated with other systemic conditions or occurs following periods of immobilization, and has a protracted clinical course, which can be frustrating for patients as well as health-care professionals. Frozen shoulder is characterized by fibroproliferative tissue fibrosis, whereby fibroblasts, producing predominantly type I and type III collagen, transform into myofibroblasts (a smooth muscle phenotype), which is accompanied by inflammation, neoangiogenesis and neoinnervation, resulting in shoulder capsular fibrotic contractures and the associated clinical stiffness. Diagnosis is heavily based on physical examination and can be difficult depending on the stage of disease or if concomitant shoulder pathology is present. Management consists of physiotherapy, therapeutic modalities such as steroid injections, anti-inflammatory medications, hydrodilation and surgical interventions; however, their effectiveness remains unclear. Facilitating translational science should aid in development of novel therapies to improve outcomes among individuals with this debilitating condition.
冻结肩是一种常见的使人虚弱的疾病，其特征是肩部疼痛和肩部运动逐渐丧失。冻结肩常与其他全身疾病有关，或在固定期后发生，具有长期的临床病程，这对患者和医疗保健专业人员来说都是令人沮丧的。冻结肩的特征是纤维增生性组织纤维化，其中成纤维细胞主要产生 I 型和 III 型胶原，转化为肌成纤维细胞（平滑肌表型），伴有炎症、新血管生成和新神经支配，导致肩部囊状纤维性挛缩和相关的临床僵硬。诊断主要基于体格检查，如果疾病处于特定阶段或存在伴随的肩部病变，则诊断可能会变得困难。治疗包括物理疗法、类固醇注射、抗炎药物、水扩张和手术干预等治疗方式；然而，其疗效尚不清楚。促进转化科学应该有助于开发新的治疗方法，以改善这种使人虚弱的疾病患者的预后。
