Jul 2026· International Journal of Drug Delivery Technology· Vol 16· 0 citations· 1 references
TL;DR
Key clinical findings may reflect rotator interval and capsular pathology in frozen shoulder, but no single test is definitive and a structured clinical examination with selective imaging may improve noninvasive diagnosis.
Abstract
Background: Frozen shoulder (FS) is characterized by pain and progressive loss of shoulder range of
motion and is commonly diagnosed by history and physical examination. However, the structural basis of key physical
examination findings remains incompletely defined. Recent studies have focused on rotator interval (RI) as a clinically
important contributor of stiffness in the FS, highlighting the need to understand the relationship between clinical
examination and arthroscopic findings for better diagnostic reasoning.
Objective: The aim of this scoping review was to map the clinical examination findings against the
arthroscopic evidence of RI and related capsuloligamentous involvement in FS, and to identify gaps in non-invasive
diagnosis.
Methods: A structured review was performed from the database inception through January 2026
according to the Joanna Briggs Institute methodology and reported in accordance with the PRISMA Extension for
Scoping Reviews. PubMed and the Cochrane Library were searched. Eligible studies were charted according to
clinical examination findings, arthroscopic or imaging findings, anatomical target, and relevance to the review
objectives. Findings were synthesized descriptively.
Results: Fifteen evidence sources were included. Passive external rotation loss, capsular-pattern
restriction, internal rotation limitation, hand-behind-back restriction, and coracoid-region pain showed plausible links
with rotator interval, coracohumeral ligament, and capsular pathology. Direct diagnostic accuracy evidence was
limited.
Conclusion: Key clinical findings may reflect rotator interval and capsular pathology in frozen
shoulder, but no single test is definitive. A structured clinical examination with selective imaging may improve noninvasive diagnosis.
Injuries to the posterolateral corner (PLC) of the knee represent a complex clinical entity that is frequently underdiagnosed and undertreated, often leading to persistent instability and failure of concomitant ligament reconstructions. Although open surgical approaches to the PLC have been extensively described, the role of arthroscopy in the diagnosis and management of these injuries remains less clearly defined despite increasingly encouraging clinical and biomechanical results. The aim of this narrative review was to analyze the role of knee arthroscopy in the diagnosis, evaluation, and treatment of PLC injuries. A comprehensive literature review was performed focusing on studies investigating arthroscopic findings, diagnostic signs, and arthroscopic or arthroscopy-assisted techniques for PLC management. Relevant clinical, anatomical, biomechanical, and surgical studies were analyzed to provide an integrated arthroscopy-oriented perspective. Arthroscopy enables direct visualization of key posterolateral structures and identification of characteristic diagnostic findings, such as the lateral drive-through sign, potentially improving detection of subtle or combined PLC injuries. In addition, arthroscopic assessment facilitates evaluation of associated intra-articular lesions and may contribute to more accurate characterization of injury patterns. Emerging arthroscopic and arthroscopy-assisted reconstruction techniques may offer advantages in selected cases by supporting tailored surgical strategies, accurate graft positioning, and reduced surgical morbidity. Knee arthroscopy is assuming an increasingly important role in the comprehensive management of PLC injuries, extending beyond the treatment of associated intra-articular pathology alone. Integration of arthroscopy into the diagnostic and therapeutic algorithm of PLC injuries may improve surgical decision-making and patient-specific management. Nevertheless, further high-quality clinical studies are required to establish standardized arthroscopic criteria and validate the long-term clinical advantages of arthroscopy-guided approaches.
C. Cobisi, F. Giustra, Alessandro Carrozzo et al.· Journal of Clinical Medicine· 0 citations
There isn't a single clinical test that can accurately identify SIJ dysfunction on its own and it is necessary to conduct additional high-quality diagnostic accuracy investigations using defined reference standards.
Arpit Bansal, Pooja Dogra, Nalina Gupta et al.· International Journal of Dru...· 0 citations
Background
Scapular-targeted rehabilitation is increasingly incorporated into the management of rotator cuff-related shoulder disorders; however, its clinical value across both conservative and postoperative stages of care remains uncertain.
Objective
To evaluate the effectiveness of scapular-targeted rehabilitation on pain, disability, and shoulder function across the rotator cuff care continuum.
Methods
A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception through May 2026. Eligible studies included adults with rotator cuff-related shoulder pain, subacromial pain syndrome, subacromial impingement syndrome, scapular dyskinesis-associated shoulder disorders, or patients undergoing rehabilitation following rotator cuff repair. Randomized controlled trials were included in quantitative synthesis. Random-effects models were used to pool standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs).
Results
Nine studies met the inclusion criteria, comprising seven randomized controlled trials, one propensity score-matched study, and one single-group pre-post study. Meta-analysis demonstrated that scapular-targeted rehabilitation significantly reduced pain compared with control interventions (SMD -0.88, 95% CI -1.71 to -0.06; I²=84.8%) and significantly improved shoulder function measured by the Constant-Murley Score (MD 6.94, 95% CI 0.37 to 13.52; I²=85.7%). Disability outcomes favored scapular-targeted rehabilitation but did not reach statistical significance (SMD -0.47, 95% CI -1.05 to 0.11; I²=72.8%). Postoperative studies generally reported favorable effects on pain, function, and range of motion, although evidence was insufficient for quantitative synthesis.
Conclusions
Scapular-targeted rehabilitation appears to be a useful adjunct within comprehensive rotator cuff rehabilitation, with evidence supporting improvements in pain and shoulder function. Evidence for disability reduction and postoperative effectiveness remains inconclusive, warranting further high-quality trials across the rotator cuff care continuum.
Abdulelah F Alshehri, Waleed O Samarkandi, Khulud A Alshahrani et al.· Orthopedic Reviews· 0 citations
ABSTRACT Introduction: The lumbar roll and modified SIMS are two common manipulation techniques used in clinical practice for sacroiliac joint dysfunction (SIJD), a common cause of low back and pelvic pain. However, there hasn’t been clear evidence of these methods’ relative clinical efficacy in recent literature. Methods: This review was registered in PROSPERO (Reg. No. CRD420251253094) and adhered to PRISMA 2020 guidelines. Studies published between January 2021 and December 2025 were found through a search of PubMed, Scopus, Web of Science, CINAHL, PEDro, Cochrane Library, and Google Scholar (first 200 results). Randomized controlled trials, quasi-experimental trials, and controlled clinical studies evaluating lumbar roll or modified SIMS manipulation in adults with SIJD using imaging-assisted criteria or validated provocation tests were all considered eligible. Screening, data extraction, and risk-of-bias assessment (RoB-2 and ROBINS-I) were carried out independently by two reviewers. Results: Nine of the 1,264 records that were found satisfied the requirements for inclusion. The number of participants in the sample varied from 30 to 90. Following manipulation, the majority of trials reported significant short-term reductions in pain (VAS/NPRS) and disability (ODI/functional measures), with lumbar roll and modified SIMS demonstrating similar clinical benefit. Improvements in pelvic alignment and mobility have been documented in several studies. There were a few transient adverse events, and no significant complications were noted. Conclusion: Although more high-quality trials are required to confirm long-term efficacy and ideal treatment protocols, lumbar roll and modified SIMS manipulation techniques consistently show short-term clinical benefits for SIJD. However, due to the absence of direct head-to-head comparisons and reliance on indirect classification of techniques, these findings should be interpreted as exploratory rather than definitive.
Farooq Islam, Umair Ahmed, C. McCarthy et al.· Archives of Physiotherapy· 0 citations
Virtual healthcare has developed rapidly and become an important part of medical care. Shoulder complaints are a common reason for seeking care and require thorough examination. Studies indicate that musculoskeletal examinations can be performed via video with good validity, but the evidence is limited. There is a need to explore, identify and map current research on the topic. The aim of this scoping review was to map and compile the existing literature on real-time video-based examination of the shoulder, to identify knowledge gaps in this area, and to describe procedures used in shoulder examinations. A literature search was conducted in November 2024 on PubMed, CINAHL and Scopus, and updated in June 2026. Grey literature was excluded. Selection of literature was performed independently by two authors. Conduct and reporting of the review followed established guidance for scoping reviews. Twenty articles were included in the review. Seven were designed as guidelines, 12 were validity or reliability studies, and one article was a case report. A result was compiled that describes the different parts of a video-based examination of the shoulder. The result also includes a description of investigated validity and reliability for individual examination components, and overall clinical assessment and diagnosis. This scoping review identified multiple studies outlining examination components and practical procedures for video-based assessment of the shoulder, suggesting the usefulness of this mode. Nevertheless, more research is necessary to establish a robust evidence base. Further research is needed to determine best practices and the appropriate role of video-based shoulder examination in musculoskeletal care. . Not applicable. This study is not a clinical trial. Not applicable. The scoping review was preregistered on 8 Nov 2024 on Open Science Framework Registry (Identifier: https://doi.org/10.17605/OSF.IO/B4C8S).
Pernilla Pålsson, Viktoria Ljung, S. Bernhardsson et al.· BMC Musculoskeletal Disorder...· 0 citations
BACKGROUND
Patellofemoral pathology is multifactorial with increasing evidence suggesting that tibiofemoral rotation (TFR) contributes to pain, maltracking and recurrent instability. Reported TFR values vary considerably because of differences in imaging modality, acquisition protocol, axial slice selection and reference axes. The aim of this review is to analyse the literature available on tibiofemoral rotation in patellofemoral pathology.
METHODS
A PRISMA-compliant systematic review of PubMed/MEDLINE, Embase and Scopus was performed up to May 2026. Studies assessing TFR in patellofemoral instability or resultant anterior knee pain were included. Data regarding imaging modality, measurement technique, reference axes, normative and pathological values, interaction with tibial tubercle indices, and clinical relevance were extracted and synthesised qualitatively.
RESULTS
Twenty-five studies were included, predominantly retrospective observational Level III studies. MRI was used in nine studies, CT alone in eight, and both modalities in four. Reference-group mean TFR values ranged from 3.8° internal to 5.7° external rotation, whereas pathological cohort means ranged from 1.6° to 12° external rotation. Where full participant ranges were reported, values overlapped substantially between healthy participants (-8.7° to 11.7°) and patellofemoral-instability cohorts (-6.5° to 21.6°). Increased external TFR was associated with patellar maltracking, recurrent instability and rotational effects on TT-TG interpretation; however, reported values were dependent on imaging modality, reference-axis definition and knee position.
CONCLUSION
Current evidence supports an association between increased external tibiofemoral rotation and patellofemoral pathology, although methodological standardisation remains necessary before TFR can be reliably incorporated into routine clinical decision-making.
Gerald J. S. Tan, Ria M. Desai, Amogh Patil et al.· Knee (Oxford)· 0 citations