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NPTE > Adhesive Capsulitis CAT > Flashcards

Adhesive Capsulitis CAT Flashcards

1
Q

What is adhesive capsulitis?

A
  • AKA frozen shoulder
  • Inflammation and fibrotic thickening of the anterior joint capsule of the shoulder
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2
Q

What happens with adhesive capsulitis?

A
  • Inflamed capsule becomes adherent to the humeral head
  • GH joint undergoes contracture
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3
Q

Classification of adhesive capsulitis

A
  • Primary
  • Secondary
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4
Q

Primary adhesive capsulitis

A
  • Occurs spontaneously, unknown etiology
  • Associated with DM, thyroid abnormalities, and cardiopulmonary conditions
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5
Q

Secondary adhesive capsulitis

A
  • Results from underlying conditions
  • Can result from trauma, immobilization, CRPS, RA, abdominal disorders, psychogenic disorders, or orthopedic intrinsic disorders
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6
Q

Which demographics are more impacted by adhesive capsulitis?

A
  • Middle-age
  • Females > males
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7
Q

Clinical presentation of adhesive capsulitis

A
  • Restricted AROM and PROM
  • Acute phase- pain radiating below the elbow, may wake up patient at night, PROM limited due to pain and guarding
  • Chronic phase- pain localized to lateral brachial region, no woken by pain, PROM restricted due to capsular stiffness
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8
Q

Capsular pattern for AC

A

ER –> abduction –> IR

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9
Q

What role does imaging play with adhesive capsulitis?

A
  • Arthrogram may detect decreased volume of fluid in the capsule
  • Other imaging is for differential diagnosis
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10
Q

Normal volume of GH joint for synovial fluid

A

16-20 mL

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11
Q

Volume of GH joint for synovial fluid w/ adhesive capsulitis

A

5-10 mL

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12
Q

Other likely observations with adhesive capsulitis

A
  • Muscle spasms due to guarding
  • Loss of reciprocal arm swing
  • Disuse muscle atrophy
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13
Q

Management of adhesive capsulitis

A
  • Usually a self-limiting process that takes 12-24 months to recover from
  • Use medications to manage pain
  • Corticosteroids may restore some ROM
  • Surgery as a last resort
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14
Q

Physical therapy treatment of adhesive capsulitis

A

Acute phase
- Ice/superficial heat
- Gentle joint mobs
- Strengthening
- Pendulums
- Isometric strengthening
Chronic phase
- Ultrasound
- Grade III/IV mobs
- PNF

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15
Q

HEP for adhesive capsulitis

A

Acute phase
- Self-stretching (avoid abduction to protect subacromial tissue)
Chronic phase
- Self-stretching
- Progressive exercise
- Posture management
- PNF
- Pendulums
- “Wall climbs”

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16
Q

Long-term outcomes w/ adhesive capsulitis

A
  • Most fully recover
  • Small percentage have some permanent loss of ROM
  • Usually they’re asymptomatic and have unimpaired function
17
Q

How to differentiate adhesive capsulitis from bursitis

A
  • Abduction >60 degrees
  • Flexion >90 degrees
  • Lasts only a few days, or will resolve itself in a few weeks

NPTE (75 decks)

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