← Blog

Rotator Cuff Injury vs. Frozen Shoulder: Differentiating Pain Causes and Enhancing Mobility with Shoulder Ultrasound and Rehabilitation

A middle-aged Hispanic man in a medical office points to his right shoulder with a concerned expression. The doctor, a Hispanic woman in her 40s, holds a shoulder joint model and a pen, explaining the differences between a rotator cuff injury and frozen shoulder. Anatomical charts of the shoulder are on the wall, and a computer on the desk displays a diagram of the shoulder joint, highlighting mobility limitations and rehabilitation options.

Shoulder pain is a common complaint in clinical practice, with two of the most frequent causes being rotator cuff injury and frozen shoulder or adhesive capsulitis. Although both conditions can present similar symptoms, such as pain and mobility limitation, it is crucial to differentiate them to provide appropriate treatment. This article explores the distinctive characteristics of each condition and the available diagnostic tools.

Diving into Differential Diagnosis

The rotator cuff injury is a common cause of shoulder pain, especially in patients over 40 years old. It is characterized by pain when lifting the arm and muscle weakness. Shoulder ultrasound and magnetic resonance imaging (MRI) are useful tools for confirming the diagnosis, as they can reveal partial or complete tears of the rotator cuff. According to a study, ultrasound has a sensitivity and specificity greater than 90% for detecting these injuries [1].

On the other hand, frozen shoulder is characterized by progressive stiffness and pain that severely limits the range of motion. Often, the diagnosis is based on clinical findings, but conventional arthrography can be helpful in confirming the decreased capacity for contrast injection in the joint, which is diagnostic of this condition [2]. Additionally, MRI may show thickening of the coracohumeral ligament and fibro-inflammatory changes in the joint capsule [3].

Conclusions

Differentiating between a rotator cuff injury and frozen shoulder is essential for guiding appropriate treatment. While rotator cuff injuries may benefit from rehabilitation and, in some cases, surgery, frozen shoulder often requires a more conservative approach, including physical therapy and, occasionally, intra-articular injections. The choice of the appropriate imaging modality, such as shoulder ultrasound or MRI, is crucial for accurate diagnosis and to avoid unnecessary interventions [4].

Referencias


Created 6/1/2025