Adhesive Capsulitis Flashcards
What is Adhesive Capsulitis?
thickening and contracture of the GH joint capsule
What are the two types of frozen shoulder?
Primary (idiopathic) - due to genetic predisposition
OR
Secondary - due to trauma or immobility
Who does adhesive capsulitis effect?
Commonly men aged 40-70
What are the risk factors for frozen shoulder? (6)
- Diabetes
- Hypothyroidism
- Pulmonary disease
- Neurological disorders
- Dupuytrens deisease
- Menopause
What are the symptoms of the Inflammation phase?
Moderately serve pain
o Gradual onset of pain
o Achy at rest
o Sharp on movement
How long does the inflammation phase last?
0-3 months
What are the symptoms of the freezing phase?
Severe pain on superolateral shoulder o Worse at night due to inflammation o Unable to lie on affected side o Difficulty with functional activity Joint line tenderness Slight loss of aROM and pROM o Mainly LR, abduction and MR Pain and stiffness on ALL accessory movements
How long does the freezing phase last?
3-9 months
What are the symptoms of the frozen phase?
Pain reduced to only at EoR
o No pain at rest
Marked stiffness due to dense scar tissue formation
o Hitching on elevation
o aROM and pROM limited in ALL directions
o accessory movements reduced
Muscle wasting evident
How long does the frozen phase last?
9-15 months
What are the symptoms of the thawing phase?
little pain, movement increasing
how long does the thawing phase last?
15-24 months
What is the pathology of the inflammation and freezing phase?
Trauma or unknown cause causes acute inflammatory response = chemical mediators released = vasodilation of joint capsule = inflammatory exudate forms = increased fibroblast and myofibroblast activity = collagen synthesis and
What is the pathology of the frozen phase?
Dense collagen matrix laid down within the JC - results in contracture
= Reduced joint volume, loss of inferior axillary fold of the JC (limiting abduction) and contraction of the coracohumeral ligament (reduced LR)
What is the pathology of the thawing phase?
Stretching of the JC aids remodelling of the collage - restoring joint ROM
