The signs of adhesive capsulitis are variable with some but rarely all of the following expected to be present: Increased vascularity of long head of biceps at rotator interval 13 Thickening of the inferior glenohumeral capsule 16Įchogenic material around the long head of biceps at rotator interval Thickened coracohumeral ligament (CHL) can be suggestive 9 Limited external rotation, identified when positioning for subscapularis tendon assessment Limitation of movement of the supraspinatus is considered a sensitive feature 7 Irregularity of the anterior capsular insertion at the anatomic neck of the humerus Limited injectable fluid capacity of the glenohumeral joint diabetes, hyperthyroidism 12ĭescribed features on fluoroscopic arthrography include: Lasts anywhere from 12 to 42 months and is defined by a gradual return of shoulder mobilityĪdhesive capsulitis is divided into two main types:Įndocrine, e.g.
The common capsular pattern of limitation has historically been described as diminishing motions with external shoulder rotation being the most limited, followed closely by shoulder flexion, and internal rotationĪ point is eventually reached in the frozen stage where pain does not occur at the end of the range of motionīegins when the range of motion starts to improve Most patients will progress to the second stageĭuring this stage, shoulder pain does not necessarily worsenīecause of pain at the end of the range of motion, arm movement may be limited, causing muscular disuse Typically lasts between 3 and 9 months and is characterized by acute synovitis of the glenohumeral joint This can eventually result in the patient seeking medical consultation Patients may not present during this stage because they think that eventually, the pain will resolve if self-treatedĪs the symptoms progress, pain worsens and both active and passive range of motion (ROM) becomes more restricted Clinical presentationĪdhesive capsulitis presentation can be broken into three distinct stages: The incidence in patients with diabetes is reported to be 2 to 4 times higher than in the general population. The incidence in the general population is thought to be 3-5%. Adhesive capsulitis typically affects women in their 5 th to 6 th decades, although patients with co-morbidities such as diabetes mellitus may develop the condition at earlier ages.
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