Adhesive Capsulitis

Question 1

What is adhesives capsulitis?

Answer 1

Frozen shoulder

A condition in which the glenohumeral joint becomes contracted and adherent to the humeral head.

Can result in shoulder pain and reduce range of movement

Question 2

What is primary adhesive capsulitis?

Answer 2

Idiopathic pathophysiology

Question 3

What is secondary adhesive capsulitis?

Answer 3

Associated with
rotator cuff tendinopathy, subacromial impingement syndrome,
biceps tendinopathy,
previous surgical intervention or trauma, inflammatory conditions and diabetes mellitus

It’s often associated with inflammatory conditions

Question 4

What are the stages of adhesive capsulitis?

Answer 4

1) painful
2) freezing stage
3) thawing stage

Question 5

What are the clinical features of adhesive capsulitis ?

Answer 5

• generalised deep and constant pain which may radiate to bicep
• stiffness and reduced function
• loss of arm swing
• atrophy of deltoid
• generalised tenderness on palpation
• external rotation and flexion affected

Question 6

What are the differentials for adhesive capsulitis?

Answer 6

• acromioclavicular pathology
• subacromial impingement syndrome
• muscle tear
• autoimmune disease

Question 7

Chat investigations are done for adhesive capsulitis?

Answer 7

Diagnosed clinically

Can do plain film radiographs but they’re just to rule out acromioclavicular pathology

MRI reveals thickening of glenohumeral joint capsule in adhesive capsulitis.

HbA1c with blood glucose can be used to diagnose any diabeties mellitus or glucose intolerance.

Question 8

How is adhesive capsulitis managed?

Answer 8

Self limiting condition and can reoccur, with lots of patients never recovering full ROM

Initially, reassure and educate to keep active and physiotherapist

Pain management sign paracetamol and NSAIDS, can do injections and oral Corticosteroids if no improvement.

Question 9

What surgical intervention can be done for adhesive capsulitis?

Answer 9

Joint manipulation under general anaesthetic to remove capsular adhesions to the humerus

Question 10

What are the complications of adhesive capsulitis?

Answer 10

• Never regain full ROM is possible
• Progression of symptoms may persist beyond two years
• May reoccur in contralateral shoulder