Search tips
Search criteria 


Logo of annrheumdAnnals of the Rheumatic DiseasesVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Ann Rheum Dis. 1996 December; 55(12): 907–914.
PMCID: PMC1010343

Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases.


OBJECTIVE: To examine the association between shoulder capsulitis and chronic diabetic complications and diseases closely related to diabetes. METHODS: A cross sectional study in 291 type I [mean (SD) age 33.2 (9.9) years] and 134 type II [61.1 (12.4) years] diabetic patients. The presence of shoulder capsulitis, Dupuytren disease, and limited joint mobility was sought. The patients were assessed for background and proliferative retinopathy, nephropathy, autonomic neuropathy, and peripheral symmetrical somatic polyneuropathy. Diseases closely related to diabetes (hypertension, history of myocardial infarction, coronary heart disease, and peripheral vascular disease) were also recorded. RESULTS: Prevalence of shoulder capsulitis was 10.3% in type I and 22.4% in type II diabetic subjects. Shoulder capsulitis was associated with the age in types I (P < 0.01) and II (P < 0.05) diabetic patients, and with the duration of diabetes in type I patients (P < 0.01). Odds ratios for autonomic neuropathy in type I and type II diabetic subjects with shoulder capsulitis were 4.1 (95% confidence interval, 1.6 to 10.9) and 2.7 (95% CI, 1.1 to 7.0), respectively, after controlling for age and duration of diabetes. Odds ratio for history of myocardial infarction in type I diabetic subjects with shoulder capsulitis was 13.7 (95% CI, 1.3 to 139.5) after controlling for age, duration of diabetes, hypertension, and smoking habits. Other associations between shoulder capsulitis and diabetic complications, related diseases, and other hand abnormalities were fully explained by age and the duration of diabetes. CONCLUSIONS: Shoulder capsulitis is common in type I and type II diabetic patients. It is associated with age in type I and II diabetic patients and with the duration of diabetes in type I patients. It is associated with autonomic neuropathy in type I and II diabetic patients and with history of myocardial infarction in type I diabetic patients, independently of time related variables.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • CHARNLEY J. Periarthritis of the shoulder. Postgrad Med J. 1959 Jul;35:384–388. [PMC free article] [PubMed]
  • STEINBROCKER O, ARGYROS TG. The shoulder-hand syndrome: present status as a diagnostic and therapeutic entity. Med Clin North Am. 1958 Nov;42(6):1533–1553. [PubMed]
  • SWAN DM. Shoulder-hand syndrome following hemiplegia. Neurology. 1954 Jun;4(6):480–482. [PubMed]
  • JOHNSON JT. Frozen-shoulder syndrome in patients with pulmonary tuberculosis. J Bone Joint Surg Am. 1959 Jul;41-A(5):877–882. [PubMed]
  • Engelman RM. Shoulder pain as a presenting complaint in upper lobe bronchogenic carcinoma: report of 21 cases. Conn Med. 1966 Apr;30(4):273–276. [PubMed]
  • OLDHAM BE. Periarthritis of the shoulder associated with thyrotoxicosis. A report of five cases. N Z Med J. 1959 Dec;58:766–770. [PubMed]
  • THOMPSON M. Shoulder-hand syndrome. Proc R Soc Med. 1961 Aug;54:679–681. [PubMed]
  • Bridgman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis. 1972 Jan;31(1):69–71. [PMC free article] [PubMed]
  • Pal B, Anderson J, Dick WC, Griffiths ID. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol. 1986 May;25(2):147–151. [PubMed]
  • Crisp AJ. Diabetes mellitus and the rheumatologist. Br J Rheumatol. 1986 May;25(2):135–137. [PubMed]
  • Fisher L, Kurtz A, Shipley M. Association between cheiroarthropathy and frozen shoulder in patients with insulin-dependent diabetes mellitus. Br J Rheumatol. 1986 May;25(2):141–146. [PubMed]
  • Morén-Hybbinette I, Moritz U, Scherstén B. The clinical picture of the painful diabetic shoulder--natural history, social consequences and analysis of concomitant hand syndrome. Acta Med Scand. 1987;221(1):73–82. [PubMed]
  • Rosenbloom AL, Silverstein JH, Lezotte DC, Richardson K, McCallum M. Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. N Engl J Med. 1981 Jul 23;305(4):191–194. [PubMed]
  • Sattar MA, Luqman WA. Periarthritis: another duration-related complication of diabetes mellitus. Diabetes Care. 1985 Sep-Oct;8(5):507–510. [PubMed]
  • Arkkila PE, Kantola IM, Viikari JS. Limited joint mobility in type 1 diabetic patients: correlation to other diabetic complications. J Intern Med. 1994 Aug;236(2):215–223. [PubMed]
  • Noble J, Heathcote JG, Cohen H. Diabetes mellitus in the aetiology of Dupuytren's disease. J Bone Joint Surg Br. 1984 May;66(3):322–325. [PubMed]
  • Murray A, Ewing DJ, Campbell IW, Neilson JM, Clarke BF. RR interval variations in young male diabetics. Br Heart J. 1975 Aug;37(8):882–885. [PMC free article] [PubMed]
  • Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. [PMC free article] [PubMed]
  • Koskinen P. Nontransferability of C-peptide measurements with various commercial radioimmunoassay reagents. Clin Chem. 1988 Aug;34(8):1575–1578. [PubMed]
  • Kouri TT, Viikari JS, Mattila KS, Irjala KM. Microalbuminuria. Invalidity of simple concentration-based screening tests for early nephropathy due to urinary volumes of diabetic patients. Diabetes Care. 1991 Jul;14(7):591–593. [PubMed]
  • Mühlhauser I. Smoking and diabetes. Diabet Med. 1990 Jan;7(1):10–15. [PubMed]
  • Eadington DW, Patrick AW, Collier A, Frier BM. Limited joint mobility, Dupuytren's contracture and retinopathy in type 1 diabetes: association with cigarette smoking. Diabet Med. 1989 Mar;6(2):152–157. [PubMed]
  • Gamstedt A, Holm-Glad J, Ohlson CG, Sundström M. Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med. 1993 Aug;234(2):189–193. [PubMed]
  • STEINBROCKER O, NEUSTADT D, BOSCH SJ. Painful shoulder syndromes; their diagnosis and treatment. Med Clin North Am. 1955 Mar;12:563–585. [PubMed]
  • Wilson PW, Anderson KM, Kannel WB. Epidemiology of diabetes mellitus in the elderly. The Framingham Study. Am J Med. 1986 May 16;80(5A):3–9. [PubMed]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group