Best Practice Case Studies-Shoulder

Pdf Summary

The document discusses adhesive capsulitis, commonly known as frozen shoulder, and provides answers and explanations for various study questions. 

1. <strong>Natural Progression and Risk Factors</strong>: Adhesive capsulitis typically progresses through three stages: freezing, frozen, and thawing. Most cases resolve spontaneously over 12-36 months. Risk factors include female gender, middle age, smoking, shoulder immobilization, and endocrine disorders, particularly thyroid disease and diabetes mellitus, with diabetics having a significantly higher risk.

2. <strong>Treatment Options</strong>: Intra-articular corticosteroid injections can offer short-term relief for symptoms and improve function, although they do not alter the condition's overall duration. There is no strong evidence supporting oral NSAIDs, oral corticosteroids, or acupuncture for this condition. The "benign neglect" approach results in outcomes similar to active interventions.

3. <strong>Imaging Findings</strong>: Diagnosis is largely clinical, with the subcoracoid triangle sign on MRI being a specific finding for adhesive capsulitis. Shoulder arthrography in affected individuals often shows reduced joint volume due to thickened joint capsules.

4. <strong>Associated Conditions</strong>: Several chronic medical conditions are associated with the onset of adhesive capsulitis, including Parkinson's disease, diabetes mellitus, hyperlipidemia, hypertension, and hypothyroidism. Trauma and surgeries resulting in shoulder immobilization can also contribute to its development.

Overall, despite various treatment modalities available, adhesive capsulitis is a self-limiting condition that typically resolves over time, highlighting the importance of managing patient expectations and focusing on symptom relief in the short term.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 50

Topic Shoulder

Keywords

adhesive capsulitis

frozen shoulder

natural progression

risk factors

treatment options

corticosteroid injections

imaging findings

associated conditions

self-limiting

symptom relief

3rd Edition

3rd Edition, CASE 50

Shoulder