Adhesive capsulitis - shoulder

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Prolonged restriction of movement and pain in the right shoulder without previous injury. No improvement with physiotherapy.

Patient Data

Age: 30 years
Gender: Male

Thickening of the axillary recess of the gleno-humeral joint (arrow) with further inflammation in the rotator cuff interval (arrow) and minor joint fluid.  No other cause for symptoms ie no rotator cuff tear or labral pathology.

Case Discussion

Adhesive capsulitis is a clinical diagnosis characterized by universal painful restriction of shoulder movement.  The MRI findings are ancillary and indicate capsular swelling and inflammation, especially in the axillary recess of the joint.  Treatment is distension arthrography and steroid injection combined with aggressive physical therapy.

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