Document Detail


The pathology of frozen shoulder. A Dupuytren-like disease.
MedLine Citation:
PMID:  7559688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Of 935 consecutive patients referred with shoulder pain, 50 fitted the criteria for primary frozen shoulder. Twelve patients who failed to improve after conservative treatment and manipulation had excision of the coracohumeral ligament and the rotator interval of the capsule. The specimens were examined histologically, using special stains for collagen. Immunocytochemistry was performed with monoclonal antibodies against leucocyte common antigen (LCA, CD45) and a macrophage/synovial antigen (PGMI, CD68) to assess the inflammatory component, and vimentin and smooth-muscle actin to evaluate fibroblasts and myofibroblasts. Our histological and immunocytochemical findings show that the pathological process is active fibroblastic proliferation, accompanied by some transformation to a smooth muscle phenotype (myofibroblasts). The fibroblasts lay down collagen which appears as a thick nodular band or fleshy mass. These appearances are very similar to those in Dupuytren's disease of the hand, with no inflammation and no synovial involvement. The contracture acts as a check-rein against external rotation, causing loss of both active and passive movement.
Authors:
T D Bunker; P P Anthony
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  77     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  1995 Sep 
Date Detail:
Created Date:  1995-10-24     Completed Date:  1995-10-24     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  677-83     Citation Subset:  AIM; IM    
Affiliation:
Princess Elizabeth Orthopaedic Hospital, Exeter, England.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Collagen / analysis
Connective Tissue Diseases / complications,  pathology*,  surgery
Contracture / pathology*,  physiopathology,  surgery
Dupuytren Contracture / complications,  pathology
Female
Fibroblasts / pathology
Humans
Ligaments, Articular / pathology
Male
Middle Aged
Range of Motion, Articular
Shoulder Joint / pathology*,  physiopathology,  surgery
Synovial Membrane / pathology
Vimentin / analysis
Chemical
Reg. No./Substance:
0/Vimentin; 9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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