{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:25:53Z","timestamp":1772828753095,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T00:00:00Z","timestamp":1553817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Frozen shoulder is a common condition, and current guidelines state that it is a diagnosis of exclusion. Along with a history and clinical examination, routine X\u2010ray is mandated, to rule out any \u201cmasquerading\u201d pathology such as fracture, dislocation, metastatic lesions or severe osteoarthritis. Despite the certainty of the guidelines there is a lack of evidence to support the use of routine X\u2010rays in this situation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed of all X\u2010rays obtained in the diagnosis of frozen shoulder between February 2014 and August 2017 in an integrated musculoskeletal interface service. Results were screened and the prevalence of masquerading pathology was determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 350 shoulder X\u2010rays that had been performed for patients with a provisional diagnosis of frozen shoulder were reviewed. Of these, 213 were from female patients (60.9%), the mean age was 57.7 (standard deviation 10.4) years and 342 (97.7%) did not have any concerning features. Six (1.7%) had severe osteoarthritis, one (0.3%) had a fracture and one (0.3%) had a lucency. All eight patients with masquerading pathology had findings from the history and clinical examination which would have warranted an X\u2010ray, regardless of a differential diagnosis of frozen shoulder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The findings of this retrospective review of a large number of X\u2010rays do not support the requirement of a routine X\u2010ray to rule out masquerading pathology to confirm the diagnosis. The data suggest that it is unnecessary for patients without a relevant clinical history suggestive of serious or masquerading pathology to undergo routine imaging.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1396","type":"journal-article","created":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T13:55:21Z","timestamp":1553867721000},"page":"288-292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Routine X\u2010rays for suspected frozen shoulder offer little over diagnosis based on history and clinical examination alone"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4796-2114","authenticated-orcid":false,"given":"Shaun","family":"Roberts","sequence":"first","affiliation":[{"name":"Integrated Physiotherapy, Orthopaedic and Pain Service Sir Robert Peel Hospital  Tamworth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Dearne","sequence":"additional","affiliation":[{"name":"Integrated Physiotherapy, Orthopaedic and Pain Service Samuel Johnson Hospital  Lichfield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Keen","sequence":"additional","affiliation":[{"name":"Integrated Physiotherapy, Orthopaedic and Pain Service Sir Robert Peel Hospital  Tamworth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Littlewood","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit Keele University  Newcastle\u2010under\u2010Lyme UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Taylor","sequence":"additional","affiliation":[{"name":"Integrated Physiotherapy, Orthopaedic and Pain Service Sir Robert Peel Hospital  Tamworth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Deacon","sequence":"additional","affiliation":[{"name":"Integrated Physiotherapy, Orthopaedic and Pain Service Samuel Johnson Hospital  Lichfield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015711"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1758-5740.2009.00007.x"},{"key":"e_1_2_10_4_1","volume-title":"The shoulder: Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa","author":"Codman E.","year":"1934"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.331.7530.1453"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2010.08.012"},{"key":"e_1_2_10_7_1","unstructured":"Hanchard N. C. A. Goodchild L. M. Thompson J. O'Brien T. Richardson C. Davison D. \u2026Scott M.(2011b).Evidence\u2010based clinical guidelines for the diagnosis assessment and physiotherapy management of contracted (frozen) shoulder. V.1.7 \u2018Standard\u2019 physiotherapy. Endorsed by the Chartered Society of Physiotherapy. Retrieved fromhttp:\/\/ccpor.ca\/wp\u2010content\/uploads\/Evidence\u2010Based\u2010Guidelines\u2010for\u2010Management\u2010of\u2010Frozen\u2010Shoulder\u2010UK\u20102011.pdf"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2013.0302"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2014.07.006"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B7.31028"},{"key":"e_1_2_10_11_1","unstructured":"National Institute for Health and Care Excellence(2014).Osteoarthritis: Care and management in adults (CG177). Retrieved fromhttps:\/\/www.nice.org.uk\/guidance\/cg177\/resources\/osteoarthritis\u2010care\u2010and\u2010management\u2010pdf\u201035109757272517"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2017.06.006"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000279"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758573215601779"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(03)00092-2"},{"issue":"5","key":"e_1_2_10_16_1","first-page":"26544","article-title":"X\u2010ray and USG correlation of cases of frozen shoulder","volume":"9","author":"Roy S.","year":"2018","journal-title":"International Journal of Recent Scientific Research"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.05.010"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5604-y"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/eb-2014-101871"},{"issue":"5","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3928\/01477447-20100329-11","article-title":"The external rotation test in the diagnosis of adhesive capsulitis","volume":"33","author":"Wolf E. 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