Frozen Shoulder

ROM Restriction , no initiating factor , global stiffness , affects external rotation

Plain X-ray normal


Stages

 1. Painful Freezing

 2. Progressive stiffness

 3. Resolution

O/e

 diffuse tenderness

 motion - active / passive both restricted

Investigations

 X-ray - to differentiate primary and secondary frozen syndrome

Bone scan - to differentiate from Reflex Sympathetic dystrophy

MRI - to rule out other pathology

Arthrosocopy - It has both therpeutic and diagnostic value.



Management

Analgesics

USG , TENS

Steroids -Intra-articular

Stretching exercises

Manipulation under anaestheisa

   sequence - flexion , extension , abduction , adduction ,external rotation , internal rotation


Arthroscopic Release

 rotator interval , MGHL , coracohumeral ligament ,


Rehabilitation

supervised ROM exercise