Adhesive Capsulitis Flashcards
What is adhesive capsulitis
Aka frozen shoulder
Glenohumeral joint capsule becomes contracted and adherent to humeral head
What is the epidemiology of adhesive capsulitis
Affects 3% of the population
More common in women
Peaks in 40-70yr olds
How is adhesive capsulitis classified
Primary adhesive capsulitis ( idiopathic )
Secondary adhesive capsulitis
What is secondary adhesive capsulitis associated with
Rotator cuff tendinopathy
impingement syndrome, biceps tendinopathy, previous surgical intervention or trauma, inflammatory conditions, and diabetes mellitus
what are the 3 stages in which adhesive capsulitis progresses
Initial painful stage, freezing stage, thawing stage
Label the shoulder joint capsule
Refer to diagram on teach me surgery
What are the clinical features of adhesive capsulitis
Generalised deep constant pain
Stiffness
Reduction in function
Examination:
- affects external rotation and flexion of shoulder
- loss of arm swinging
- loss of deltoid muscle
what are the differential diagnoses
Acromioclavicular pathology
Subacromial impingement syndrome
Muscular tear
Autoimmune disease
What are the investigations you would carry out
Plain x rays - to rule out other pathology
MRI
HbA1c
What is the conservative management of adhesive capsulitis
Education and reassurance
Keep active
Physiotherapy
NSAIDs
When is the surgical management of these patients indicated
3 months following conservative treatment if no improvement
what is the surgical management
Joint manipulation under general anaesthetic to remove capsular adhesions to humerus
what are the complications of adhesive capsulitis
never regain a full range of motion
progression of symptoms may persist beyond two years
may recur in the contralateral shoulder.
