HEMNATH RAJENDRAN PREFINAL YR.

Frozen shoulder
- glenohumeral joint becomes painful and stiff . -Also known as periarthritis, adhesive capsulitis
Most common in females . Above 40-60yrs

HISTORY
Dupley- humeroscapular periarthritis Codman frozen shoulder Neviaser- adhesive capsulitis

ANATOMY
shoulder joint is a ball-and-socket joint involving articulation between glenoid fossa of scapula and head of humerus. The head of the upper arm bone fits into a shallow socket in scapula. Strong connective tissue, called the shoulder capsule, surrounds the joint.

Causes

Primary - idiopathic cause

SecondaryShoulder causes tendonitis of rotator cuff , bicipital tendonitis . Fractures , dislocations around the shoulder . Non shoulder causesdiabetes , cardiovascular diseases with reffered pain , complication of colles fracture , prolonged immobilization.

PATHOLOGY
abduction & repeated overhead activities of shoulder . Long head of biceps and rotator cuff undergo repeated strain leads to -inflammation -fibrosis -consequent thickening of shoulder capsule - wasting of muscles

CLASSICAL STAGES REEVES

Stage of pain Stage of stiffness Stage of recovery

CLINICAL FEATURES
Decreased range of active &passive movements - Capsular pattern of movement restrictions - Pain noted at end stage of stretch - Resistive test is pain free in available range of movements - Unable to do routine activities - Night pain
-

RADIOLOGY- Usually normal - Golding sign - Sclerosis in greater tuberosity.

golding sign

TREATMENT

Conservative treatment aims at relieving pain and prevent further suffering

Analgesics , antiinflammatory drugs excercises Pendulum exercise patient. leans forward at the hips and moves his arms as if stirring a giant pudding . manipulation under General Anaesthesia may improve movements. Shoulder is moved gently and firmly into external rotation then abduction and flexion . At the end joint is injected with lidnocaine and methyl prednisolone. arthroscopy

ARTHROSCOPY