Adhesive Capulitis (Frozen Shoulder)

Question 1

Define adhesive capsulitis

Answer 1

Formation of excessive scar tissue in the glenohumeral joint leading to stiffness, pain and dysfunction

Question 2

Describe a primary and secondary adhesive capsulitis

Answer 2

Primary has an idiopathic onset

Secondary occurs due to a specific known event

Question 3

State 7 risk factors of adhesive capsulitis

Answer 3

Females, age 40+, being HLA-B27 positive, diabetes, hypothyroidism, cerebrovascular disease and coronary artery disease

Question 4

How many stages are there?

Answer 4

4

Question 5

What occurs in stage 1? (4)

Answer 5

Shoulder pain, synovitis, inflammatory cell infiltration, pain at night

Question 6

What occurs in stage 2? (5)

Answer 6

Stiffness, pain, synovitis, loss of axillary fold and synovial proliferation

Question 7

What occurs in stage 3? (6)

Answer 7

Global loss of ROM, pain at end of range, synovitis resolved, significant adhesions, dense collagenous tissue

Question 8

What occurs in stage 4? (3)

Answer 8

Persistent stiffness, minimal pain and advanced adhesions

Question 9

What physio treatment can be given? (7)

Answer 9

Mobilisation
Education
NSAIDS
Steroids
Hydrodilation
Manipulation under anaesthetic
Capsular release