Adhesive Capsulitis



Adhesive Capsulitis


Adam Lyons, MD

Rahul Kapur, MD, CAQSM



BASICS


DESCRIPTION



  • Commonly known as “frozen shoulder”


  • Painful restriction of glenohumeral joint range of motion (ROM)


  • Caused by thickening, fibrosis, and contraction of glenohumeral joint capsule with adherence to the humeral head


  • Classified into two categories:



    • Primary, which has an insidious idiopathic onset with no precipitating event


    • Secondary, which follows trauma, immobilization, or underlying systemic illness


EPIDEMIOLOGY



  • Slight predominance in females, 1.4:1


  • Mean age of onset is ˜55 yr of age; rare before 40 yr


  • 15% experience bilateral disease


  • No known racial or ethnic predilection


Prevalence

3% of the general population; prevalence is 10-20% in patients with diabetes mellitus.


ETIOLOGY AND PATHOPHYSIOLOGY



  • Exact pathophysiology of condition is unclear.


  • Increasing evidence suggests the process involves synovial inflammation with subsequent reactive fibrosis.


  • Pain is due to synovial inflammation.


  • Resultant capsular fibrosis restricts ROM.


  • Generally idiopathic


  • Can result from period of shoulder immobilization


  • Rarely, also arises from clinically significant trauma to shoulder, cervical radiculopathy, brachial plexus pathology, or rotator cuff tendonitis


  • Autoimmune theory of disease: Microvascular disease causes abnormal collagen repair, leading to capsular fibrosis.


RISK FACTORS



  • Shoulder immobilization increases risk by 5 to 9 times over the general population (1).


  • Diabetes mellitus: 10-20% prevalence (1,2)


  • Thyroid disease


  • Stroke


  • Female gender


  • Age 40 to 70 yr



GENERAL PREVENTION

Avoidance of prolonged shoulder immobilization or severe restriction of movement


COMMONLY ASSOCIATED CONDITIONS



  • Diabetes


  • Thyroid disorders


  • Hypertriglyceridemia


  • Cervical spondylosis




DIAGNOSIS


HISTORY

Tags:
Mar 14, 2020 | Posted by in SPORT MEDICINE | Comments Off on Adhesive Capsulitis

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