M Frozen shoulder Flashcards
What is a frozen shoulder also known as?
adhesive capsulitis
What is frozen shoulder/adhesive capsulitis?
- unknown aetiology in which there
- is a painful global restriction of GH movements in all planes,
- both active and passive,
- in the absence of joint degeneration sufficient to explain this restriction
What age group tend to affected by frozen shoulder?
greater than 40 yrs
usually 60 yrs
What gender tends to be affected?
females
Is it likely to relapse?
no
Is prevalence high in diabetics or non-diabetics?
diabetics
What illnesses are associated with frozen shoulder? (4)
- diabetes mellitus- type 1 (40%)
- thyroid disease
- lung disease
- cardiac disease or surgery
What are the general symptoms of frozen shoulder?
1.Painful (2-9/12)
- ache
- night pain
- spasm
2.Adhesive (2-9/12)
- pain
- stiffness
- ↑ restriction
3.Resolution (1-2yrs)
- Less pain
- gradual resolution
What is seen on examination in patients with frozen shoulder?
- Early diff to d/w RCD
- Tender trapezius
- Global↓ROM (active & passive) - Scapulohumeral rhythm
- Disuse atrophy
What is the pathophysiology of frozen shoulder implicate?
- DM - microvascular element
- abnormal collagen repair
- increase infection
What is seen in the histology of frozen shoulder?
- increase in fibrous tissue
- increase fibroblasts
- type III collagen
- vascularity increases
- synovial cells
Is there HCA or immunological disturbance?
No
In terms of genetics what is increased with those with chronic disease?
trisomy 7 and 8 in fibroblasts
What is the early phase like in frozen shoulder?
more like neuropathic pain with allodynia
What is the late phase like in frozen shoulder?
similar to dupytrens in histology but with a different outcome
