Adhesive Capsulitis

Adhesive capsulitis is a common condition resulting in pain and decreased passive (and therefore active) motion of the shoulder. Primary risk factors include diabetes mellitus and hypothyroidism, while secondary factors include trauma and prior surgery. Inflammation of the synovium and fibrosis of the capsule lead to contracture of the glenohumeral capsule. Clinical stages include inflammatory, frozen, and thawing. Arthroscopic stages are descriptive and include the condition and appearance of the capsule, synovium, and adhesions, if present. Radiographs are typically normal, and MRI often shows a thickened capsule. Treatment is typically nonoperative with physical therapy, NSAIDs, and intra-articular cortisone injection. If nonoperative measures fail, surgical options are sometimes employed, including manipulation and debridement.