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PD – Frozen Shoulder Association — SCE Neurology MCQ

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ModerateMovement DisordersPD – Frozen Shoulder AssociationSCE Neurology

A 50-year-old man with PD presents with severe pain in his right shoulder. The shoulder is stiff and painful on passive movement, particularly external rotation and abduction. X-ray shows no fracture or dislocation. Ultrasound shows adhesive capsulitis. Is there a relationship between this and his PD?

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Correct answer: D — Frozen shoulder (adhesive capsulitis) is more common on the side of initial PD symptom onset and may precede the diagnosis of PD by months to years

Frozen shoulder (adhesive capsulitis) has a well-recognised association with PD, occurring more commonly on the initially affected side. In some patients, shoulder pain and stiffness precede the diagnosis of PD by 1–2 years, reflecting early bradykinesia and rigidity in the affected limb leading to reduced shoulder movement and secondary adhesive capsulitis. It is important to consider PD in patients presenting with unilateral frozen shoulder, especially if subtle parkinsonian features are present on examination. A: The association is well-established. C: It is related to the disease, not treatment. D: Levodopa does not cause it. E: It can occur without trauma due to PD-related immobility.

Reference: van der Windt et al. Shoulder Pain and PD; NICE NG71