Frozen shoulder (adhesive capsulitis)

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" As the name implies, movement of the shoulder is severely restricted in

people with a " frozen shoulder. " This condition, which doctors call

adhesive capsulitis, is frequently caused by injury that leads to lack

of use due to pain. Rheumatic disease progression and recent shoulder

surgery can also cause frozen shoulder. . . . People with diabetes,

stroke, lung disease, rheumatoid arthritis, and heart disease, or who

have been in an accident, are at a higher risk for frozen shoulder. The

condition rarely appears in people under 40 years old. "

Source:

Nucleaus Catalog Medical Reference Library

" Frozen Shoulder (Adhesive Capsulitis) " :

http://catalog.nucleusinc.com/displaymonograph.php?MID=38

" RA commonly involves the shoulders. RA in the shoulders is manifested

by tenderness, nocturnal pain, and limited motion. Initially, swelling

occurs anteriorly, but it may be difficult to detect and is present on

examination in a minority of patients at any point in time. Rotator cuff

degeneration secondary to synovitis may limit abduction and rotation.

Superolateral migration of the humerus occurs with complete tears.

Glenohumeral damage leads to pain both with motion and at rest and

typically leads to severely restricted motion or " frozen shoulder

syndrome. " Acromioclavicular arthritis is not as frequent or as

disabling. "

Source:

eMedicine.com

" Rheumatoid Arthritis " :

http://www.emedicine.com/pmr/topic124.htm

" More than 40% of working-aged adults reported neck or arm pain. Pain

was more common among women and with advancing years. Hand

osteoarthritis affected 2% of men and 5% of women. Frozen shoulder and

shoulder tendinitis affected up to 5% of our population and tennis elbow

almost 1%. More worrying, over half of those with pain were having

difficulty sleeping, getting dressed or driving a car. These findings

are important, since they quantify the extent of soft tissue rheumatism

in the working population. "

Source:

Arthritis Research Campaign

April 2002

http://www.arc.org.uk/newsviews/arctdy/116/spotlight.htm

" Etiology: Duplay was one of the first physicians to present the concept

of periarticular tissue pathology, rather than periarticular arthritis,

as the cause of frozen shoulder. Despite a lack of evidence linking

frozen shoulder to a specific etiology, various triggers that may

predispose patients to this problem appear to exist. A few of these

reported etiologic agents include trauma, surgery (including but not

limited to the shoulder), inflammatory disease, diabetes, regional

conditions, and various shoulder maladies that have been reported to

have similar pathological findings.

In addition, an autoimmune theory has been postulated, with elevated

levels of C-reactive protein and an increased incidence of HLA-B27

histocompatibility antigen reported in patients with frozen shoulder

versus controls. DePalma proposed that muscular inactivity was a major

etiologic factor, while Bridgman identified an increased incidence of

FSS in patients with diabetes mellitus. Finally, frozen shoulder also

has been associated with cervical disease, hyperthyroidism, and ischemic

heart disease.

Common to most patients with FSS is a period of shoulder immobilization.

Reasons for immobilization can be diverse; however, the common finding

in all of these patients is a period of restricted shoulder motion. In a

study of neurosurgery patients who immobilized their shoulders for

varying periods, Bruckner et al noted an incidence of frozen shoulder of

5-9 times the incidence in the general population. "

Source:

eMedicine.com

" Adhesive Capsulitis " :

http://www.emedicine.com/orthoped/topic372.htm

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org