Adhesive capsulitis (Frozen shoulder)

Question 1

What is adhesive capsulitis?

Answer 1

This is an inflammatory condition of the shoulder capsule resulting in stiffness and reduced movement of the shoulder

Question 2

Who is most at risk of adhesive capsulitis?

Answer 2

Females
Aged 40-50

Question 3

What are some conditions associated with adhesive capsulitis?

Answer 3

Diabetes
Endocrine disease
Dupuytren’s

Question 4

What causes adhesive capsulitis/

Answer 4

Contracture and thickening of the coraco-humeral ligamen, the rotator interval and the axillary fold, resulting in a decrease in joint volume and thus restricting movement

Question 5

What are the 3 stages of adhesive capsulitis?

Answer 5

• Freezing
• Frozen
• Thawing

Question 6

How will adhesive capsulitis present?

Answer 6

Anterior pain at rest or at night, with severe joint stiffness and global reduction in range of movement

External rotation will often be <50% of normal

Question 7

What are some conditions that can mimic adhesive capsulitis?

Answer 7

Glenohumoral arthritis
Locked posterior dislocation

Question 8

How long will it take adhesive capsulitis to clear on its own?

Answer 8

3-4 years

Question 9

What are some non-operative managements to support self-limitation in adhesive capsulitis?

Answer 9

Gentle movement
Physiotherapy
Analgesia
Glenohumeral steroid injections
Fluoroscopic distension

Question 10

What are the 2 main operative managements in adhesive capsulitis?

Answer 10

• Manipulation under anaesthetic (Causes increased ligamentous laxity without pain)
• Arthropscopic capsular release (Arthrolysis)