Adhesive capsulitis is a commonly occurring condition in the general orthopaedic population. The relationship of frozen shoulder to diabetes mellitus, hypercholesterolaemia, Dupuytren disease and epilepsy is well established, although the casual relationship has to be fully elucidated. Many studies reported that adhesive capsulitis is more frequently observable in middle-age females; therefore it was hypothesised that this condition was correlated to autoimmune and/or chronic inflammatory diseases that are not so rare in women and in that period of life. We evaluated whether some blood values related to inflammatory or autoimmune diseases, lipaemia and glycaemia might be considered a prognostic index of capsulitis. Material: Thirty patients with adhesive capsulitis (mean age 54 years) were clinically evaluated and prospectively followed at the moment of the freezing phase. Two patients developed shoulder stiffness after a trauma and successive immobilisation; one was epileptic, two had previously sustained shoulder arthroscopic decompression for subacromial impingement. The remaining twenty-five capsulites were considered idiopathic. The left and right shoulders were equally involved. None of the patients had evidence of Dupuytren's contracture in the hand. Initially, we investigated ESR and CRP, the serum lipid and sugar levels. Autoantibodies (ANA; ASMA; anti-dsDNA; APGC, fibrinogen and rheumatoid factor (RF) were also studied. Over time, all these parameters were repeatedly studied. Results: At the moment of the first clinical evaluation, 5 patients (17%) were considered diabetic (4 cases non-insulin dependent and 1 insulin dependent; 15 (53%) affected by hypercholesterolaemia; 12 l(40%) and 4 (13%) had high values of ESR and CRP, respectively. Incidence and high titer of at least one autoantibody were noticed in 47% of the studied cohort. Over time, nineteen patients obtained a complete range of motion only with physical therapy; the remaining eleven had little or no progress in decreasing pain or increasing mobility with conseryative treatment; therefore they underwent manipulation and arthroscopic capsular release. In patients with diabetes and hypercholesterolaemia, serum lipid and sugar levels remained high; as well as CRP and RF. Percentage of patients with positive serum for autoantibodies decreased

Adhesive capsulitis: may it be considered an autoimmune condition? / Gumina, Stefano; D., Di Marcantonio; G., Di Giorgio; Postacchini, Franco. - STAMPA. - (2005), pp. 229-229. (Intervento presentato al convegno 20th SECEC congress tenutosi a Athens (Greece) nel 20-23 September, 2006).

Adhesive capsulitis: may it be considered an autoimmune condition?

GUMINA, STEFANO;POSTACCHINI, Franco
2005

Abstract

Adhesive capsulitis is a commonly occurring condition in the general orthopaedic population. The relationship of frozen shoulder to diabetes mellitus, hypercholesterolaemia, Dupuytren disease and epilepsy is well established, although the casual relationship has to be fully elucidated. Many studies reported that adhesive capsulitis is more frequently observable in middle-age females; therefore it was hypothesised that this condition was correlated to autoimmune and/or chronic inflammatory diseases that are not so rare in women and in that period of life. We evaluated whether some blood values related to inflammatory or autoimmune diseases, lipaemia and glycaemia might be considered a prognostic index of capsulitis. Material: Thirty patients with adhesive capsulitis (mean age 54 years) were clinically evaluated and prospectively followed at the moment of the freezing phase. Two patients developed shoulder stiffness after a trauma and successive immobilisation; one was epileptic, two had previously sustained shoulder arthroscopic decompression for subacromial impingement. The remaining twenty-five capsulites were considered idiopathic. The left and right shoulders were equally involved. None of the patients had evidence of Dupuytren's contracture in the hand. Initially, we investigated ESR and CRP, the serum lipid and sugar levels. Autoantibodies (ANA; ASMA; anti-dsDNA; APGC, fibrinogen and rheumatoid factor (RF) were also studied. Over time, all these parameters were repeatedly studied. Results: At the moment of the first clinical evaluation, 5 patients (17%) were considered diabetic (4 cases non-insulin dependent and 1 insulin dependent; 15 (53%) affected by hypercholesterolaemia; 12 l(40%) and 4 (13%) had high values of ESR and CRP, respectively. Incidence and high titer of at least one autoantibody were noticed in 47% of the studied cohort. Over time, nineteen patients obtained a complete range of motion only with physical therapy; the remaining eleven had little or no progress in decreasing pain or increasing mobility with conseryative treatment; therefore they underwent manipulation and arthroscopic capsular release. In patients with diabetes and hypercholesterolaemia, serum lipid and sugar levels remained high; as well as CRP and RF. Percentage of patients with positive serum for autoantibodies decreased
2005
20th SECEC congress
shoulder adhesive capsulitis; shoulder stifness
04 Pubblicazione in atti di convegno::04b Atto di convegno in volume
Adhesive capsulitis: may it be considered an autoimmune condition? / Gumina, Stefano; D., Di Marcantonio; G., Di Giorgio; Postacchini, Franco. - STAMPA. - (2005), pp. 229-229. (Intervento presentato al convegno 20th SECEC congress tenutosi a Athens (Greece) nel 20-23 September, 2006).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/489069
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