QuestionSBA
QuestionChoice
NICE guidance states to offer analgesia, particularly in the early, painful phase. Paracetamol is considered first-line. Regular dosing is more effective than 'as required use'. If paracetamol is ineffective, consider an oral NSAID (for example, ibuprofen) or codeine.
10005356
a
Simple analgesia
QuestionChoice
This is a type of scan typically only requested by secondary care specialists.
10005360
e
MRI
QuestionChoice
This is appropriate if the person has had pain and/or stiffness for up to three months and has not benefited from conservative measures.
10005358
c
Referral to secondary care
QuestionChoice
NICE states to consider an intra-articular (glenohumeral) corticosteroid injection early in the course of frozen shoulder if there is no, or slow, progress with initial conservative treatment.
10005357
b
Intra-articular (glenohumeral) corticosteroid injection
QuestionChoice
This is typically only requested by secondary care specialists to investigate the rotator cuff and is particularly useful in diagnosing shoulder impingement, shoulder instability or rotator cuff disorders.
10005359
d
Ultrasound scan
Concept
Chapter
2693
4391
Frozen shoulder
Topic
145
Orthopaedics
13618
A 74-year-old diabetic man attends his GP with a six-week history of a painful and slightly stiff right shoulder. He complains of not being able to dry his hair or sleep at night due to the pain. On examination, there is restriction in all movements of his shoulder due to the pain but most significantly reduced passive external rotation. You suspect adhesive capsulitis (frozen shoulder).

Which of the following is the best next step in the management of this patient in primary care?
a