教你一招 | 如何诊断粘连性肩关节囊炎

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原文：https://radiopaedia.org/articles/adhesive-capsulitis-of-the-shoulder

Adhesive capsulitis of the shoulder , also known as frozen shoulder , is a condition characterised by thickening and contraction of the shoulder joint capsule and surrounding synovium. Adhesive capsulitis can rarely affect other sites such as the ankle .

粘连性肩关节囊炎 ，也称冻结肩，其特征是肩关节囊和周围滑膜的增厚和挛缩。粘连性关节囊炎很少影响其他部位，如踝关节。

Epidemiology

The incidence in the general population is thought to be 3-5%. Adhesive capsulitis typically affects women in the 5 th to 6 th decades of life, although patients with co-morbidities such as diabetes may develop the condition at earlier ages. The incidence in patients with diabetes is reported to be 2 to 4 times higher than in the general population.

流行病学

一般人群的发病率为3-5％。粘连性关节囊炎通常见于50-60岁的女性，患有糖尿病等并发症的患者发病年龄可能会提前。糖尿病患者的发病率高于普通人群的2〜4倍。

Clinical presentation

Adhesive capsulitis presentation can be broken into three distinct stages:

• freezing: painful stage

• patients may not present during this stage because they think that eventually, the pain will resolve if self-treated.

• as the symptoms progress, pain worsens and both active and passive range of motion (ROM) becomes more restricted

• this can eventually result in the patient seeking medical consultation

• typically lasts between 3 and 9 months and is characterised by an acute synovitis of the glenohumeral joint

• frozen: transitional stage

• most patients will progress to the second stage

• during this stage, shoulder pain does not necessarily worsen

• because of pain at end ROM, use of the arm may be limited causing muscular disuse

• can last between 4 to 12 months

• the common capsular pattern of limitation has historically been described as diminishing motions with external shoulder rotation being the most limited, followed closely by shoulder flexion, and internal rotation

• there eventually becomes a point in the frozen stage that pain does not occur at the end of ROM

• thawing stage

• begins when ROM begins to improve

• lasts anywhere from 12 to 42 months and is defined by a gradual return of shoulder mobility

临床症状：

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