Periarthritis shoulder or adhesive capsulitis or frozen shoulder is very common condition of shoulder joint. Contents : Definition Epidemiology Classification Causes clinical features DIFFERENTIAL DIAGNOSIS Diagnosis :- INVESTIGATION Examination MEDICAL TREATMENT

1. PERIARTHRITIC SHOULDER
PRESENTED BY :- YASH N. ANGHAN
( FROZEN SHOULDER ) OR ( ADHESIVE CAPSULITIS )
OR ( PAINFULL STIFF SHOULDER )
AKA

2. CONTENTS
• DEFINITION
• EPIDEMIOLOGY
• CLASSIFICATION
• CAUSES
• CLINICAL FEATURES
• DIFFERENTIAL DIAGNOSIS
• DIAGNOSIS :- INVESTIGATION
• EXAMINATION
• MEDICAL TREATMENT
PRESENTED BY :- YASH N. ANGHAN

3. DEFINITION
“A CONDITION OF VARYING SEVERITY CHARACTERIZED BY THE GRADUAL
DEVELOPMENT OF GLOBAL LIMITATION OF ACTIVE AND PASSIVE SHOULDER MOTION
WHERE RADIOGRAPHIC FINDINGS OTHER THAN OSTEOPENIA ARE ABSENT.”
~ AMMARICAN ACADEMY OF ORTHOPEDIC SURGEONS
~ JHON EBNAZER
“ IT IS DEFINED AS A CLINICAL SYNDROME CHARACTERIZED BY PAINFUL RESTRICTION
OF BOTH ACTIVE AND PASSIVE SHOULDER MOVEMENTS DUE TO CAUSES WITHIN THE
SHOULDER JOINT OR REMOTE “
PRESENTED BY :- YASH N. ANGHAN

4. Epidemiology
• PREVELANCE :- F > M ; RATIO : F : M = 10 : 8
:- MORE COMMONLY UNILATERAL
• INCIDANCE : IN GENERAL POPULATION : 2 % - 5 %
: IN DIABETEC POPULATION : 10 % – 35 %
• MEAN AGE : 40 – 60 YEARS ( COMMONLY START IN 40 – 45 YEARS OF AGE )
PRESENTED BY :- YASH N. ANGHAN

5. Classification & causes
SECONDARY P.S.
PRIMARY P.S.
• Idiopathic • Secondary to any Condition
Systemic Intrinsic Extrinsic
- Diabetes mellitus
- Hypothyroidism
- Hyperthyroidism
- Hypoadrenalism
- Rotator cuff tendinitis
- Rotator cuff tears
- Biceps tendinitis
- Calcific tendinitis
- AC arthritis
- Cardio pulmonary
disease
- Cervical disc
- Humerus fractures
- Parkinson's
PRESENTED BY :- YASH N. ANGHAN

6. STAGES OF PERIARTHRITIC SHOULDER
Clinical features
FREEZING STAGE
( Stage of pain )
(10 – 36 Weeks )
FROZEN STAGE
( Stage of stiffness )
( 4 -12 Months )
THAWING STAGE
( stage of recovery )
( ½ to 2 Years )
• Acute pain
• Reduced Range of
motion mainly
external rotation
then abduction
followed by
forword flexion
• Pain gradually
decreased
• Only few degrees
of movements has
remained
• Very slight
movements
• No pain
• Movements are
recovered
• But can not be
regained as normal
PRESENTED BY :- YASH N. ANGHAN

7. Other Clinical features
• TENDERNESS OVER JOINT SURFACE
• DECREASED RANGE OF AROM AND PROM BOTH
• CAPSULAR PATTERN : EXTERNA ROTATION
: ABDUCTION
: INTERNAL ROTATION
• PAIN WORSEN AT NIGHT AND RADIATES TOWORDS ARM
• OVERHEAD ACTIVITIES ARE HARD TO PERFORM ! SUCH AS : COMBING AND OILING OF HAIR
• ACTIVITIES THAT INCLUDES EXTERNAL ROTATION ARE VERY HARD TO PERFORM ! SUCH AS :
BUTTONING OF BLOUSE
PRESENTED BY :- YASH N. ANGHAN

8. DIFFERENTIAL DIAGNOSIS
• ACROMIOCLAVICULAR ARTHROPATHY
• AUTOIMMUNE DISEASE (E.G., SYSTEMIC LUPUS ERYTHEMATOSUS,
RHEUMATOID ARTHRITIS)
• BICEPS TENDINOPATHY
• GLENOHUMERAL OSTEOARTHRITIS
• NEOPLASM
• SUBACROMIAL AND SUBDELTOID BURSITI
• ROTATOR CUFF TENDINOPATHY OR TEAR (WITH OR WITHOUT
IMPINGEMENT)
PRESENTED BY :- YASH N. ANGHAN

9. DIAGNOSIS
INVESTIGATION
PRESENTED BY :- YASH N. ANGHAN
• Periarthritic shouldercan be
diagnosed mainly signs and
symptoms
• X – Rays Are mostly normal But it can
show golding sign
• But radiographs, Ultrasound or MRI is
Done to rule out differential
diagnosis
EXAMINATIONS
• It will be done by faculty
member

10. TREATMENT
PHYSIOTHERAPY TREATMENT
MEDICAL TREATMENT
• NSAIDS IN INITIAL STAGE
• INTRAARTICULAR STEROIDS
( GIVES ONLY TEMPORARY RELIEF )
• IT WILL BE DONE BY FACULTY
MEMBER
PRESENTED BY :- YASH N. ANGHAN

11. REFFERENCES
• ESSENTIAL ORTHOPAEDICS INCLUDING CLINICAL
METHODS BY J. MAHESHWARI
• TEXTBOOK OF ORTHOPAEDICS BY JOHN EBNAZER
• APLEY’S SYSTEM OF ORTHOPEDIC AND FRACTURE BY
LOUIS SOLOMON
• TEXTBOOK OF ORTHOPAEDICS BY EDWARD L NAZARETH
PRESENTED BY :- YASH N. ANGHAN

12. THANK YOU FOR
SUPPORT
PRESENTED BY :- YASH N. ANGHAN