Fig. 1.

Key elements of the inflammatory-fibrotic cascade underlying shoulder stiffness (SS), which may allow to hypothesize an underlying metabolic/pro-inflammatory systemic condition, characterized by TNF-α/TGF-β hyperexpression. Abbreviations: HGF: hepatocyte growth factor; IL: interleukin; MMP: matrix metalloproteinases; PDGF: platelet-derived growth factor; TGF-β: transforming growth factor-β; TIMP, tissue inhibitors of metalloproteinases; TNF-α: tumor necrosis factor-α.