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Self-limited but very debilitating disease
Caused by acute inflammation of the capsule followed by scarring and remodeling
Very painful shoulder triggered by minimal or no trauma
Pain out of proportion to clinical findings during the inflammatory phase
Commonly seen in patients 40- to 65-years-old
More common in women than men, especially in perimenopausal women or in patients with endocrine disorders, such as diabetes mellitus or thyroid disease
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Painful shoulder that has limited range of motion
Strength is usually normal but can appear diminished when the patient is in pain
There are three phases
Inflammatory phase usually lasts 4–6 months; patients complain of a very painful shoulder without obvious clinical findings of trauma, fracture, or rotator cuff tear
"Freezing" phase usually lasts 4–6 months; shoulder becomes progressively stiffer even though the pain is improving
"Thawing" phase can take up to a year as the shoulder slowly regains its motion
Total duration of an idiopathic frozen shoulder
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Usually a clinical diagnosis; an extensive work-up is not necessary
However, standard anteroposterior, axillary, and lateral glenohumeral radiographs are useful to rule out glenohumeral arthritis
Imaging can also rule out calcific tendinitis
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During the acute "freezing" phase,
Anti-inflammatory medication is not as helpful during the "thawing" phase as it is during the "freezing" phase
Surgical treatments include manipulation under anesthesia and arthroscopic release