Idiopathic adhesive capsulitis of the shoulder: a review

Bruè, S.; Valentin, Anders; Forssblad, Magnus; Werner, Suzanne; Mikkelsen, Christina; Cerulli, G.

doi:10.1007/s00167-007-0291-2

Cited by 153 publications

(141 citation statements)

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“…Radiographs are often normal in adhesive capsulitis but may show some decreased bone mineral density [3]; however, in this case, there is a clear lytic lesion in the humeral head and neck on the plain Wlms. It is unclear whether these Wlms were reported by a radiologist.…”

mentioning

confidence: 69%

Re: Metastatic pathological fracture of the surgical neck of humerus during manipulation under anaesthesia for adhesive capsulitis

Ferran

Ashford

2011

Eur J Orthop Surg Traumatol

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We have read the above case report with interest and would like to raise several points with respect to investigation into and management of this case [1].The patient in this case had a painful shoulder with a history of recurrent breast cancer, and while treatment for breast cancer has been associated with frozen shoulder [2], tumour should have been top of the list of diVerential diagnoses in this case.A 4-month history of severe progressive pain, bony tenderness and restricted range of motion also does not Wt with the initial phase of adhesive capsulitis in which pain is not usually associated with stiVness and tenderness is usually elicited over the joint capsule [2].Radiographs are often normal in adhesive capsulitis but may show some decreased bone mineral density [3]; however, in this case, there is a clear lytic lesion in the humeral head and neck on the plain Wlms. It is unclear whether these Wlms were reported by a radiologist. We are of the opinion that an MRI was indicated at this initial stage. An isolated lytic lesion with a distant history (>10 years) warrants further investigation and should be treated as a primary bone tumour until proven otherwise.The authors claim that conservative management failed to alleviate pain; however, they have not elaborated on the treatment methods used or the duration. By their own admission, capsular release and MUA are used for recalcitrant cases to improve stiVness. Some authors recommend a minimum of 4 months but usually 6 months before considering surgical management [2].It is unclear why the arthroscope was reinserted when a pathological fracture was suspected. Image intensiWer Wlms would have provided the diagnosis of fracture without risk of tumour seeding.A pathological fracture was suspected; however, MRI scan was refused. Biopsy does not seem to have been considered in this case, and its role has not been discussed. A biopsy at this stage may have reduced the 3-month delay in diagnosis. No mention has been made of staging of disease once the diagnosis of metastasis had been made. The tumour was resected and the patient Wtted with a spacer. This warrants clariWcation as the gold standard for treatment of an isolated metastatic proximal humerus metaphyseal fracture is wide excision and replacement with a modular prosthesis [4]. This case as described demonstrates the need for adhesive capsulitis to be a diagnosis of exclusion, highlights the controversies in its management, and illustrates deWciencies in the workup of patients with suspected bone tumours.

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confidence: 69%

Re: Metastatic pathological fracture of the surgical neck of humerus during manipulation under anaesthesia for adhesive capsulitis

Ferran

Ashford

2011

Eur J Orthop Surg Traumatol

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“…23,32 The patient's shoulder condition described in this case best matched a stage 2 presentation. Although adhesive capsulitis is considered to involve primarily the capsular tissue, 1,3,6,25 the pain the patient experienced was most likely due to myofascial trigger points, indicating that the synovitis stage had resolved. Furthermore, significant gains in ROM after the pain was reduced suggest that capsule fibrosis, which is characteristic of stage 3, had likely not developed.…”

Section: Discussionmentioning

confidence: 99%

“…Active shoulder ROM was not measured during this session. Treatment Session 6 The patient reported that her pain level after the previous treatment and at rest was 2/10 on the NPRS. This pain was described as unfamiliar muscle soreness in the upper trapezius and deltoid, in the areas where dry needling was performed.…”

Section: Interventionmentioning

confidence: 99%

Trigger Point Dry Needling as an Adjunct Treatment for a Patient With Adhesive Capsulitis of the Shoulder

Clewley¹,

Flynn²,

Koppenhaver³

2014

J Orthop Sports Phys Ther

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A dhesive capsulitis is a common shoulder condition of unknown etiology that is often treated by physical therapists. 26,47 The incidence rate of adhesive capsulitis is higher in women than in men and higher among middleaged individuals. 47 The risk factors associated with adhesive capsulitis are type 1 or 2 diabetes mellitus, thyroid disease, an age of between 40 and 65 years, trauma, prolonged immobilization, autoimmune disease, and myocardial infarction. 23 In individuals with diabetes, the incidence rate is upward of 20%, compared to 2% to 5% in individuals without diabetes. 15,37The economic burden and the impact of adhesive capsulitis on health care expenditures are significant. 9,43 The condition has been described as self-limiting, typically resolving in 1 to 3 years, with long-term range of motion (ROM) deficits lasting up to 10 years. 27 However, the prognosis associated with adhesive capsulitis improves with a lesser number of comorbidities. 48There are a number of invasive and conservative options for managing adhesive capsulitis. 7,8,13,23,44 Invasive interventions include intra-articular steroid injection, surgery, and manipulation under anesthesia. Manipulation under anesthesia is commonly used but carries the risk of humeral fracture, dislocation, rotator cuff injuries, labral tears, and brachial plexus injury.13 Acetaminophen and nonsteroidal anti-inflammatory medications are common first-line nonsurgical treatments for adhesive capsulitis, but there is little evidence for their effectiveness. 44 Oral corticosteroids might provide short-term benefit in pain relief and improved ROM in patients with adhesive capsulitis.7 However, they have not been proven to reduce the duration of adhesive capsulitis. 8Early physical therapy intervention that includes joint mobilization directed at the shoulder joint complex has been T T STUDY DESIGN: Case report. T T BACKGROUND:Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1 to 3 years. Conservative treatment that includes physical therapy is commonly advised. T T CASE DESCRIPTION:The patient was a 54-year-old woman with primary symptoms of shoulder pain and loss of motion consistent with adhesive capsulitis. Manual physical therapy intervention initially consisted of joint mobilizations of the shoulder region and thrust manipulation of the cervicothoracic region. Although manual techniques seemed to result in some early functional improvement, continued progression was limited by pain. Subsequent examination identified trigger points in the upper trapezius, levator scapula, deltoid, and infraspinatus muscles, which were treated with dry needling to decrease pain and allow for higher grades of manual intervention. T T OUTCOMES:The patient was treated for a total of 13 visits over a 6-week period. After trigger point dry needling was introduced on the third visit, improvements in pain-free shoulder range of motion and functional outcome measures, assessed with the Shoulder Pain and Disability Index and the shortened form...

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“…[6,21] While there are investigators who accept concomitant diseases such as diabetes and hyperthyroidism as also being idiopathic, others consider these to be secondary to AC. [6,21,22] In this study, the rate of concomitant diabetes was 31.7% in the AC group and 11.7% in the SIS group.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Generalized Joint Hypermobility and Adhesive Capsulitis of the Shoulder

et al. 2013

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Amaç: Bu çalışmada generalize eklem hipermobilitesi (GEH) ve omzun adeziv kapsüliti (AK) arasındaki muhtemel ilişki araştırıldı. Hastalar ve yöntemler:Çalışma grubunda 120'si AK tanılı ve kontrol grubunda 120'si primer subakromiyal sıkışma sendromu tanılı olmak üzere, toplam 240 hasta çalışmaya dahil edildi. Her iki grupta da ağrı şiddeti, omuz eklem hareket açıklığı, fonksiyonel değerlendirme, engellilik ve hipermobilite değerlendirildi. Generalize eklem hipermobilitesi Beighton skoru, benign eklem hipermobilite sendromu (BEHS) ise revize Brighton kriterleri ile değerlendirildi. Bulgular: Adeziv kapsülit grubunda, GEH sadece bir hastada (%0.08) olmak üzere oldukça nadir (p<0.05) saptanırken, BEHS'ye rastlanmadı. Kontrol grubunda ise dokuz hastada (%7.5) GEH, beş hastada (%4.2) BEHS gözlendi.Sonuç: Çalışma bulgularımız, GEH'in AK gelişimi için koruyucu veya önleyici bir faktör olabileceğini göstermektedir. Klinik pratikte, GEH olan hastalarda gelişen omuz ağrılarında, tablonun AK'ye dönüşümü açısından daha iyimser olunabileceğine inanıyoruz. Generalize eklem hipermobilitesi bulunan hastalarda AK gelişimi söz konusu ise, bu hastalar tedaviye daha iyi yanıt verebilir.Anahtar sözcükler: Adeziv kapsülit; benign eklem hipermobilite sendromu; sıkışma sendromu.Objectives: This study aims to investigate the possible relationship between generalized joint hypermobility (GJH) and adhesive capsulitis (AC) of the shoulder. Patients and methods:A total of 240 patients were enrolled in this study, including 120 patients diagnosed with AC in a study group and 120 patients diagnosed with primary subacromial impingement syndrome in the control group. We evaluated the pain severity, range of motion of the shoulder joint, functional status, disability, and hypermobility in both groups. The Beighton score was used to evaluate the GJH while the revised Brighton criteria were utilized for the patients with benign joint hypermobility syndrome (BJHS). Results:In the adhesive capsulitis group, GJH was significantly rare (p<0.05) with only one patient (0.08%) whereas BJHS was not found. In the control group, nine patients (7.5%) had GJH, and five (4.2%) had BJHS. Conclusion:Our study results suggest that GJH may be a protective or preventive factor in the development of AC. In clinical practice, we believe that in GJH patients we can be more optimistic regarding the concern of the conversion of shoulder pain to AC. If this has already taken place, then these patients may respond more positively to treatment in cases involving GJH.

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Idiopathic adhesive capsulitis of the shoulder: a review

Cited by 153 publications

References 50 publications

Re: Metastatic pathological fracture of the surgical neck of humerus during manipulation under anaesthesia for adhesive capsulitis

Re: Metastatic pathological fracture of the surgical neck of humerus during manipulation under anaesthesia for adhesive capsulitis

Trigger Point Dry Needling as an Adjunct Treatment for a Patient With Adhesive Capsulitis of the Shoulder

The Relationship Between Generalized Joint Hypermobility and Adhesive Capsulitis of the Shoulder

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