Adhesive capsulitis(Frozen shoulder)

Question 1

describe what adhesive capsulitis(frozen shoulder) is characterised by

Answer 1

progressive pain and stiffness of shoulder in 40-60 y/o, resolving after around 18-24months

Question 2

what is the principal clinical sign seen in frozen shoulder

Answer 2

loss of external rotation, along with restriction of other movements

Question 3

what other disease presents with similar clinical signs as frozen shoulder and what is the difference between them

Answer 3

OA, but OA usually seen in older patients

Question 4

what condition is particularly prone to adhesive capsulitis

Answer 4

diabetes

Question 5

what pathology is seen in adhesive capsulitis

Answer 5

the capsule and glenohumeral ligaments become inflamed then thicken and contract

Question 6

describe the usual progression of frozen shoulder

Answer 6

initial pain subsides in 2-9months, stiffness increases for around 4-12months, then ‘thaws’ out over time, usually with good recovery of shoulder motion

Question 7

what conservative management can be used for frozen shoulder

Answer 7

physiotherapy, analgesics, intra-articular injections may be helpful in pain phase

Question 8

what treatment can be used of patient is unable to tolerate loss of function due to stiffness of shoulder

Answer 8

manipulation under anaesthetic(MUA, which tears the capsule), or surgical capsular repair(which divides capsule to improve function)