Patient case: Adhesive Capsulitis (Frozen Shoulder)
A 50-year-old woman presents with a 9-month history of progressive pain and stiffness in her left shoulder. The symptoms began gradually, with mild discomfort during overhead movements, but have since worsened, limiting her ability to reach for objects on shelves or even comb her hair. She also reports difficulty sleeping due to shoulder pain, particularly when lying on the affected side.
She has no history of trauma or injury to the shoulder, but has type 2 diabetes, which she has managed with oral medications for the past five years. On physical examination, there is a significant restriction of both active and passive range of motion in the left shoulder, with external rotation being the most limited. Tenderness is noted around the deltoid region, but no signs of swelling or deformity are present.
Based on her clinical presentation and examination findings, she is diagnosed with adhesive capsulitis. Conservative treatment, including physical therapy focused on stretching exercises, pain management with non-steroidal anti-inflammatory drugs (NSAIDs), and possible corticosteroid injections, is discussed as the initial management plan.
a). Sharp pain during exercise
b). Progressive pain and stiffness in the left shoulder
c). Numbness and tingling in the arm
d). Swelling around the shoulder joint
a). Hypertension
b). Osteoarthritis
c). Type 2 diabetes
d). Hyperthyroidism
a). Increased range of motion in the shoulder
b). Tenderness over the acromioclavicular joint
c). Significant restriction of both active and passive range of motion
d). Visible swelling and deformity of the shoulder
a). Immediate surgical intervention
b). Physical therapy and pain management
c). Complete immobilization of the shoulder
d). Oral corticosteroids
