Chapter 74 - Adhesive Capsulitis

Question 1

histology of adhesive capsulitis tissue

Answer 1

perivascular mononuclear cells, absence of synovial lining, extensive subsynovial fibrosis

Question 2

increased cytokines in adhesive capsulitis?

Answer 2

TNF-A
IL-1
TGF-B
PDGF

Question 3

capsular contractures

Answer 3

glenohumeral volume reduced
obliteration of the axillary fold
thickening of the rotator interval
contracture of the coracohumeral ligament

Question 4

greatest risk factor for adhesive capsulitis?

Answer 4

previous diagnosis of adhesive capsulitis in the contralateral shoulder

Question 5

hormonal associations

Answer 5

DM
Hypothyroid

Question 6

systemic ds associations

Answer 6

cardiovascular ds

Question 7

neurologic ds association

Answer 7

parsonage turner syndrome
parkinsons
CVA

Question 8

other associated conditions

Answer 8

mastectomy/lumpectomy
chest wall surgery
dupuytrens

Question 9

outcomes of oral corticosteriods

Answer 9

helpful for pain relief acutely

no measurable benefit at 6 weeks

Question 10

outcomes of intraarticular CSI

Answer 10

proven for both pain and ROM improvement at short term follow up

long term is equivalent to PT only

Question 11

outcomes of arthroscopic capsular release in post-surgical adhesive capsulitis vs idiopathic capsulitis

Answer 11

post-surgical is more likely to resolve spontaneously over time, and has poorer outcomes than idiopathic following surgical release (less pain improvement, less rom improvement, less patient satisfaction)

Question 12

long term outcomes of arthroscopically released adhesive capsulitis

Answer 12

7 year data with excellent return of function (similar to contralateral shoulder)