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23 - Shoulder Dislocation - D3

23 - Shoulder Dislocation - D3 - Adhesive Capsulitis(Frozen...

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Adhesive Capsulitis (Frozen Shoulder)
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Definition A disorder in which the shoulder capsule becomes inflamed and stiff, greatly restricting motion and causing pain. The etiology is unknown (injury or trauma, autoimmune). Characterized by progressive pain and stiffness which usually resolves spontaneously after 18 months. Movement of the shoulder is severely restricted, pain is worse at night.
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Clinical Features Age 40-60, more in females Slight wasting, some tenderness. Pain (gradual onset) Stiffness or decrease in motion. External rotation (most severely inhibited) Internal rotation. Abduction.
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Radiology X-ray: Osteoporosis of the proximal humerus (decreased bone density) Arthrography: Shows a contracted joint Dramatic decrease in the injected contrast material. Loss of normally loose dependent folds of the capsule.
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Differential Diagnosis Post-traumatic stiffness (maximal at the start, gradually lessens) Disuse stiffness Regional pain syndrome (associated with MI, stroke) www.icareunit.com
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Treatment self-limiting: it usually resolves over time without surgery. Movement is regained gradually but may not return to normal Conservative: Analgesics Heat therapy and exercise(physiotherapy) Corticosteroid injection. Manipulation under anesthesia hastens recovery. Operative Treatment Arthroscopic division of the interval between supraspinatous and infraspinatous (improve the range of movement).
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Shoulder Instability Shoulder Instability (Dislocation) (Dislocation)
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