adhesive capsulitis (frozen shoulder)

Question 1

what is it?

Answer 1

inflammation and fibrosis of the joint capsule leading to contracture of shoulder joint

Question 2

what is it associated with?

Answer 2

diabetes
hypercholesterolaemia
endocrine disease
Dupuytren’s disease

Question 3

what is the pathophysiology?

Answer 3

ligaments get thicker and less elastic

Question 4

what is pathophysiology of a freezing shoulder?

Answer 4

painful, increased stiffness
minimal synovitis with pain, causing a limitation of motion

Question 5

what is the pathophysiology of frozen shoulder?

Answer 5

ROM limited, less painful
pain decreased but proliferative synovitis with contraction of capsule and adhesion of axillary recess increases

Question 6

what is pathophysiology of thawing shoulder?

Answer 6

inflammation decreased, movement slowly improves

Question 7

what are symptoms?

Answer 7

pain at night
pain at rest
anterior pain
stiffness

Question 8

what are the signs?

Answer 8

global restriction in ROM especially in external rotation

Question 9

what investigations are used?

Answer 9

clinical diagnosis
imaging - may be used to cause stiffness and pain

Question 10

what is the management?

Answer 10

fluroscopic distension
manipulation under anaesthetic
physio and analgesia