[8] Adhesive Capsulitis

Question 1

What is adhesive capsulitis also known as?

Answer 1

Frozen shoulder

Question 2

What is adhesive capsulitis?

Answer 2

A condition in which the glenohumeral joint capsule becomes contracted and adherent to the humeral head

Question 3

What can adhesive capsulitis result in?

Answer 3

Shoulder pain and a reduced range of movement in the shoulder joint

Question 4

What % of the population are affected by adhesive capsulitis?

Answer 4

Approx 3% of population

Question 5

Which gender is adhesive capsulitis more common in?

Answer 5

Females

Question 6

When does the incidence of adhesive capsulitis peak?

Answer 6

40-70 years old

Question 7

What are people who have previously been affected by adhesive capsulitis susceptible to?

Answer 7

Developing the condition in the contralateral shoulder

Question 8

What can adhesive capsulitis be categorised as?

Answer 8

Primary or secondary

Question 9

What is primary adhesive capsulitis caused by?

Answer 9

Idiopathic

Question 10

What is secondary adhesive capsulitis commonly associated with?

Answer 10

• Rotator cuff tendinopathy
• Subacromial impingement syndrome
• Biceps tendinopathy
• Previous surgical intervention or trauma
• Inflammatory conditions
• Diabetes mellitus

Question 11

Classically, what are the three stages of progression of adhesive capsulitis?

Answer 11

1. Initial painful stage
2. Freezing stage
3. Thawing stage

Question 12

What is the problem with the three stage model of adhesive capsulitis?

Answer 12

There is little evidence to support these phases, and the pain associated with limitation in shoulder movement is thought to be present throughout

Question 13

What are the symptoms of adhesive capsulitis?

Answer 13

• Pain
• Stiffness
• Reduction in function

Question 14

Describe the pain in adhesive capsulitis

Answer 14

It is a generalised deep and constant pain of the shoulder, which may radiate to the bicep. It often disturbs sleep

Question 15

What will be found on examination with adhesive capsulitis?

Answer 15

• There may be loss of arm swing and atrophy of the deltoid muscle
• Generalised tenderness on palpation is common, with poor localisation of pain
• Patient will have limited range of motion, principally affecting external rotation and flexion of the shoulder. A full range of movement should prompt consideration of alternative diagnoses

Question 16

What are the differential diagnoses of adhesive capsulitis?

Answer 16

• Acromioclavicular pathology
• Subacromial impingement syndrome
• Muscular tears
• Autoimmune disease

Question 17

Give three examples of acromioclavicular pathologies

Answer 17

• Acromioclavicular joint injury
• Acromioclavicular arthritis
• Glenohumeral arthritis