Frozen shoulder Flashcards
What is this also known as?
Adhesive capsulitis
Describe the condition
The joint capsule becomes contracted and adheres to humeral head
- common cause of shoulder pain and reduced range of movement
Who does it commonly affect?
Middle aged women
Peak age of onset = 40-70
What is it associated with?
Diabetes - up to 20% of diabetics may have an episode of frozen shoulder
Inflammatory conditions - may be autoimmune element
What are the main features?
Typically patients have a painful freezing phase, an adhesive phase and a recovery phase
Is it true that external rotation is affected more than internal rotation or abduction?
Yes
How will patients typically describe the pain?
Generalised, deep and constant
May radiate to bicep
Can cause waking from sleep
What features are seen on examination?
Loss of arm swing
Reduced range of motion - principally external rotation and flexion
Atrophy of deltoid
Generalised tenderness on palpation
Are both active and passive movements affected?
Yes
It is bilateral in up to what % of patients?
20%
How long does the episode typically last?
6 months to 2 years
A proportion will never fully recover full ROM
How is it diagnosed?
Clinically although imaging may be required for atypical or persistent symptoms
How is it managed?
No single intervention shown to improve outcome long term
NSAIDS
Physio
Oral corticosteroids and intra articular
What differentials are there?
Acromioclavicular pathology
Subacromial impingement syndrome
Muscle tear
Autoimmune disease - RA, SLE, PMR
What is seen on a plain film?
Generally unremarkable
