Adhesive Capsulitis

Question 1

What is another name for adhesive capsulitis?

Answer 1

1. Frozen shoulder

Question 2

What is the MOI?

Answer 2

1. Idiopathic (loss of active and passive motion, can’t move shoulder pass a certain point)
   *shoulder stiffness due to inflammation

Question 3

What groups will have an increased incidence of adhesive capsulitis?

Answer 3

1. 40-60
2. DM
3. Hypothyroidism

**can be increased with Dupuytren’s, cervical disc herniation, Parkinson’s cerebral hemorrhage

Question 4

What are the clinical symptoms of adhesive capsulitis?

Answer 4

1. Freezing phase progresses with increasing loss of motion
2. Pain until thawing phase occurs then will be slow improvements of symptoms

Question 5

Will the patient be fully back after the thawing phase?

Answer 5

1. Most patients will have a motion deficit

Question 6

What will be on the PE?

Answer 6

1. Loss of motion compared to contralateral shoulder
   *50% or more
   *loss of ER
   *painful motion (end ranges worst)
   *tender at deltoid insertion

Question 7

What are the diagnostic tests to do?

Answer 7

1. Shoulder radiographs
2. MR arthrogram (inject die into the MRI)

Question 8

What is the treatment options

Answer 8

1. NSAIDs
2. Heat
3. Therapy (gentle ROM, work around inflammation)
4. Ice
5. TENs
6. Intra-articular CI

Question 9

Is manipulation okay to use for a frozen shoulder?

Answer 9

1. Yes
   *risk factor would be surgery
   *complete under anesthesia

Question 10

When to refer?

Answer 10

1. Little to no improvement after 3 months