Adhesive Capsulitis (Frozen Shoulder) - Pathogenesis and Clinical Findings • Primary (Idiopathic): Unknown etiology, but associated with autoimmune disorders (diabetes mellitus, thyroid disease) • Secondary (less common): Prolonged shoulder injury (i.e. post shoulder surgery, rotator cuff tear, humeral head fracture) or Prolonged shoulder immobility (i.e. after a stroke that caused hemiplegia, or during recovery after breast/heart surgery) => In select populations (age 40-60, women > men), the glenohumeral joint capsule ligaments become inflamed, usually in one (non-dominant) shoulder => Over time, active shoulder joint inflammation as post-inflammatory healing (i.e. local connective tissue scarring) Increase => Months later, active shoulder joint inflammation will stop, but post-inflammatory tissue healing creates abundant scar tissue => Years later, scar tissue in the joint space &capsule will eventually break down by itself, to be replaced by healthy, flexible ligaments First stage, lasts 2 - 9 months • Shoulder pain: Diffuse throughout shoulder, Severe, worse at night, Disabling (i.e. can't sleep on painful side) Second Stage, lasts 4 - 12 months • Decr Shoulder pain • Incr Shoulder stiffness (progressive restriction of shoulder movement) Third Stage, lasts 5 - 24 months • No shoulder pain • Shoulder Stiffness (decr active AND passive range of motion in shoulder; any movement is mostly scapulothoracic) #AdhesiveCapsulitis #FrozenShoulder #pathophysiology #diagnosis #symptoms #signs #stages #staging #msk
