Week 1: Shoulder Adhesive Capsulitis: AKA the Frozen Shoulder Syndrome Flashcards

1
Q

What is adhesive capsulitis?

A

Condition w/ pain and stiffness or motion loss in the shoulder

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2
Q

Symptoms associated w/ adhesive capsulitis

A
  • Sleep deprivation
  • Anxiety
  • Disability
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3
Q

Average duration of adhesive apsulitis

A

30.1 months

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4
Q

How common is adhesive capsulitis

A
  • 5.3% of population
  • 10-38% of pop w/ diabetes or thyroid disease
  • Females > males
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5
Q

Pathogenesis of adhesive capsulitis

A

Cause unknown, results in:

  • Hardening of redundant axillary folds
  • Synovial capsule thickening
  • Contracture of GH joint
  • Dense adhesions on the synovial capsule
  • Significant loss of AROM/PROM
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6
Q

Classifications for adhesive capsulitis

A
  • Primary (idiopathic)

- Secondary

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7
Q

Primary (idiopathic) adhesive capsulitis

A
  • Histological
  • Neuronal
  • Vascular
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8
Q

Histological changes in adhesive capsulitis

A
  • Inflammatory cytokines
  • Fibroblasts - myofibroblasts
  • Lymphocytes
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9
Q

Neuronal and vascular abnormalities

A

Increased vascularity in the anterosuperior joint capsule but not in the inferior or posterior capsule

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10
Q

Secondary adhesive capsulitis

A
  • Systemic
  • Extrinsic (outside the joint)
  • Intrinsic (inside the joint)
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11
Q

Systemic Secondary adhesive capsulitis

A
  • Diabetes mellitus
  • Hypothyroidism
  • Hyperthyroidism
  • Hypoadrenalism
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12
Q

Extrinsic Secondary adhesive capsulitis

A
  • Cardiopulmonary disease
  • Cervical disc
  • CVA
  • Humerus fractures
  • Parkinson’s
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13
Q

Intrinsic Secondary adhesive capsulitis

A
  • Rotator cuff tendinitis
  • Rotator cuff tears
  • Biceps tendinitis
  • Calcific tendinitis
  • AC arthritis
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14
Q

Stages of adhesive capsulitis

A

Stages 1-4

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15
Q

Adhesive capsulitis stage 1

A
  • 0-3 months
  • Non-capsular limitations
  • Pain w/ AROM/PROM
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16
Q

Adhesive capsulitis stage 2

A
  • “Freezing”
  • 3-9 months
  • Capsular pattern limitation
17
Q

Adhesive capsulitis stage 3

A
  • “Frozen”
  • 9-15 months
  • High irritability
  • Rigid end feel
18
Q

Adhesive capsulitis stage 4

A
  • “Thawing”
  • 15-24 months
  • Low irritability
  • Gradual return ROM
19
Q

Patient presentation for adhesive capsulitis

A
  • Gradual and progressive onset of pain
  • Rain at end ranges of movement
  • Painful and restricted AROM/PROM in elevation and rotation for 1+ month
20
Q

Capsular pattern in adhesive capsulitis

A

ER –> ABD –> IR

21
Q

Differential diagnosis for adhesive capsulitis

A

Diagnostic imaging usually needed

22
Q

Treatment options for adhesive capsulitis

A
  • Wait and see
  • PT
  • Oral steroid
  • Corticosteroid injections
  • Manipulation under anesthesia
  • Arthroscopy
23
Q

Level A evidence for adhesive capsulitis

A

Steroid injections + PT

24
Q

Level B evidence for adhesive capsulitis

A
  • Pt education

- Stretching

25
Q

Level C evidence for adhesive capsulitis

A
  • Modalities

- Mob/manip