IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic, Bologna, University of Bologna, Bologna, Italy.
Physical Therapy and Rehabilitation Unit, Policlinico Di Modena, Modena, Italy.
Eur J Orthop Surg Traumatol. 2024 Dec;34(8):4113-4121. doi: 10.1007/s00590-024-04098-z. Epub 2024 Sep 28.
Adhesive capsulitis (AC), often referred to as frozen shoulder, presents a diagnostic challenge due to its insidious onset and progressive nature. The condition is characterized by pain and restricted motion in the shoulder, with a predilection for individuals between 40 and 60 years of age. A novel scoring system was developed to enhance the accuracy of diagnosing AC and distinguishing between its stages, aiming to streamline clinical decision-making and treatment planning.
A cohort of patients with symptoms suggestive of AC was assessed using the new scoring system, which integrates clinical, radiological, and patient history factors. Parameters included comorbidities like diabetes mellitus, recent immobility, rotator cuff tears, and specific ultrasound findings. Patients were scored and categorized into definitive AC, uncertain diagnosis, or exclusion from AC, with scores > 7, 6-2, and < 2, respectively.
The scoring system effectively categorized patients, with those scoring > 7 demonstrating pronounced symptoms and ultrasound changes consistent with Phase 2 AC. Patients with scores between 6 and 2 were classified into uncertain Phase 1 or Phase 3, necessitating further observation. Scores < 2 effectively excluded AC, indicating a need to explore alternative diagnoses.
The structured scoring system demonstrated potential as a comprehensive tool for diagnosing AC. By quantitatively assessing a range of contributory factors, it allowed for the stratification of the disease into distinct stages. This system is anticipated to improve early diagnosis and the precision of treatment interventions, although further validation in larger cohorts is warranted.
II-III.
粘连性肩关节囊炎（AC），通常被称为冻结肩，由于其隐匿性发病和渐进性特点，诊断具有挑战性。该疾病的特征是肩部疼痛和运动受限，好发于 40 至 60 岁人群。一种新的评分系统被开发出来，以提高 AC 诊断的准确性，并区分其不同阶段，旨在简化临床决策和治疗计划。
一组有 AC 症状的患者使用新的评分系统进行评估，该系统综合了临床、影像学和患者病史因素。参数包括糖尿病等合并症、近期活动受限、肩袖撕裂和特定的超声发现。患者根据评分分为明确的 AC、不确定诊断或排除 AC，评分分别>7、6-2 和<2。
评分系统有效地对患者进行了分类，评分>7 的患者表现出明显的症状和与 2 期 AC 一致的超声改变。评分在 6 到 2 之间的患者被归类为不确定的 1 期或 3 期，需要进一步观察。评分<2 有效地排除了 AC，表明需要探索其他诊断。
结构化评分系统有望成为诊断 AC 的综合工具。通过定量评估一系列促成因素，它可以将疾病分层为不同阶段。该系统有望提高早期诊断和治疗干预的准确性，但需要在更大的队列中进一步验证。
II-III。
