Adhesive capsulitis. NPTE Study Guide: Master the NPTE

Adhesive capsulitis/Idiopathic frozen shoulder/periarthritis

Development of dense adhesive fibrosis & scarring in shoulder capsule = restricted AROM & PROM. Caused by chronic inflammation & may be seen in rotator cuff, biceps tendon, & synovial tissue.

Primary frozen shoulder

No known cause. May provoke chronic inflammation in musculotendinous or synovial tissue, like the rotator cuff, biceps tendon, or joint capsule.

Secondary frozen shoulder

Seen w/ previous shoulder issues w/ a period of pain &/or restricted motion ie RA, trauma, immobilization

Stage 1

> 3 months duration. Gradual onset of pain that increases w/ movement & is present at night. Loss of ext rot w/ intact rotator cuff strength is common.

Freezing

3-9 months. Persistent & intense pain even at rest. Limited motion in all directions & cannot be fully restored with an intra-articular injection.

Frozen

9-15 months. Pain only w/ movement, significant adhesions, & limited GH motions. Excessive scapulothoracic is a typical compensation. Deltoid, rotator cuff, biceps, & tricep atrophy.

Thawing

15-24 months. Minimal pain, no synovitis but significant capsular restrictions from adhesions. Gradual motion improvement. May never regain normal ROM.