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[Adhesive capsulitis of the shoulder]
1Service de rééducation et de réadaptation de l'appareil locomoteur, Hôpital Cochin, Paris.
La Revue Du Praticien
|October 20, 1999
Summary
Adhesive capsulitis, a stiff shoulder condition, involves painful capsule thickening and fibrosis. While often self-healing, treatments like joint distension or manipulation under anesthesia can help severe cases.
Area of Science:
- Orthopedics
- Rheumatology
- Sports Medicine
Context:
- Adhesive capsulitis, commonly known as a frozen shoulder, presents as a painful, stiff shoulder condition.
- Pathological changes include synovitis and capsular fibrosis, resembling Dupuytren's disease.
- Stiffness primarily affects shoulder flexion, lateral rotation, and abduction.
Purpose:
- To describe the pathophysiology, clinical presentation, and treatment options for adhesive capsulitis.
- To inform clinicians about the natural history and therapeutic interventions for frozen shoulder.
Summary:
- Adhesive capsulitis is characterized by shoulder joint capsule and synovium thickening, leading to significant stiffness and pain.
- Hyperemia of the synovium and capsular fibrosis are key pathological findings.
- Spontaneous resolution occurs in most cases within 12-30 months.
Impact:
- Non-operative management, including joint distension and rehabilitation, can alleviate pain and improve function in disabling cases.
- Surgical interventions, such as manipulation under anesthesia or arthroscopic soft tissue release, are considered for significant stiffness and disability.