Evaluation of serological factors and their relationship with Constant Shoulder Score in frozen shoulder patients

Rouhani, Alireza; Elmi, Asghar; Danesh, Hesam; Parish, Masoud; Dashti, Mohsen; Hamedfar, Hadi; Mahdipour, Shahab

doi:10.22034/ijos.2025.521020.1134

Evaluation of serological factors and their relationship with Constant Shoulder Score in frozen shoulder patients

Document Type : Original Article

Authors

Alireza Rouhani ¹

Asghar Elmi ¹

Hesam Danesh ¹

Masoud Parish ²

Mohsen Dashti ³

Hadi Hamedfar ⁴

Shahab Mahdipour ¹

¹ Department of Orthopedics, Shohada Hospital, Faculty of Medicine, Tabriz University of Medical Sciences

² Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences

³ Department of Radiology, Faculty of Medicine, Tabriz University of Medical Sciences

⁴ Physical medicine and Rehabilitation research center, Tabriz University of Medical sciences

https://doi.org/10.22034/ijos.2025.521020.1134

Abstract

Abstract
Objective: Frozen Shoulder is a painful and debilitating illness that affects 2 to 5% of the general population, characterized with significant shoulder pain and reduced mobility, resulting in loss of passive and active movements.This is a cross-sectional study to evaluate serological factors in these patients and their relationship with Constant Shoulder Score (CSS) which may be of diagnostic benefit.
Material and Method: Frozen shoulder (Adhesive Capsulitis) cases referring within 4 months of the disease were considered for the study (referred sample). Diagnostic criteria for adhesive capsules included: 1) limited and painful shoulder for at least 4 weeks, 2) severe shoulder pain that interfered with daily life or work performance, 3) nocturnal pain, 4) painful limitation of raising active and passive to less than 100 degrees, and 5) limitation of at least 50% in external rotation. After primary clinical evaluations, a series of specific blood tests were requested and the shoulder range of motion and scores were recorded The mean levels of fasting blood glucose (FBS), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) CRP levels and associated with constant shoulder score (CSS) were documented.

Results: Fifty patients with frozen shoulder referred to the orthopedics clinic of a tertiary teaching hospital within one year period were included. A total of 29 patients with adhesive capsulitis were assigned to the study, of whom 22 were female (76%) and 7 male (24%). The mean levels of fasting blood glucose (FBS), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) were 100.61 ± 17.29 mg/dL, 16.89 ± 13.14 mm/h and 2.85 ± 6.88 mg/L, respectively. CRP levels were inversely associated with constant shoulder score (CSS).
Conclusion: The serum level of CRP might be a reliable biomarker for predicting the qualitative state of pain and range of motion in patients with adhesive capsulitis.

Keywords

Adhesive Capsulitis

Frozen Shoulder

Serologic Tests

Hematologic Tests

Subjects

Shoulder & Elbow

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