Adhesive Capsulitis of the Shoulder

Abstract

Adhesive capsulitis is the primary cause of loss of movement of the shoulder, other causes being trauma, rotator cuff dysfunction and arthritis. It consists of a restriction in the range of both passive and active movements of the shoulder; Has a prevalence of 2-5% of the population and is more common in diabetic patients (11-20%). Primary adhesive capsulitis is idiopathic, but there are theories involving endocrinological, immunological, inflammatory and biomechanical mechanisms; while the secondary is of known cause, either intrinsic or extrinsic (systemic). Clinically it is characterized by three phases: painful, adhesive and resolutive. Distinguishing adhesive capsulitis and impingement syndrome can clinically be difficult, as symptoms, in addition to the dysfunction of the muscles of the rotator cuff, in conjunction with rupture can lead to adhesive capsulitis, or coexist both entities overlap. Among the sonographic findings in adhesive capsulitis they are: hypervascularity and loss of echogenicity intervals rotator thickening coracohumeral ligament, sonographic evidence of movement restriction, fluid in the bicipital groove, fluid in the more lateral aspect of the subdeltoid bursa and integrity of the tendons of the rotator cuff muscles.