Shoulder adhesive capsulitis: may prognosis be deducible by blood exams?

Purpose: We evaluated if some blood values related to inflammatory or autoimmune diseases, lipaemia and glycemia might be considered as a prognostic index of shoulder adhesive capsulitis (AC) ; furthermore, we observed if with time these values may influence the outcome. Material and Methods: 76 patients with idiopathic AC (mean aged 56) were clinically evaluated and prospectively followed at the moment of their freezing phase. Initially ; we investigated ESR and CRR the serum lipid and sugar levels. ANA-ASMA'anti-dsDNA-APGC-anti-TSHr'arLti-TPO-anri'Tg, fibrinogen and rheumatoid factor were also studied. At first, 20 patients were surgically treated, while physical therapy was adopted for the remaining 56. Shoulder ROM was separately analysed for conservatively and surgically treated patients and it was then related to blood values. After 4 months, all parameters were re-studied. Wc used Constant Score (CS) method to assess shoulder function. Results: 19 patients (25 %) had alterations of glucose metabolism; 50 {65,7 %) were affected by hypercholesterolemia; 37 (48%) and 24 (31.5%) had high values of ESR and CRP, respectively ; fibrinogen and rheumatoid factor were respectively elevated in 15 (]9.7%)and 16(21%).Highrateof ASMA was noticed in 25%. After 4 months, no blood value seemed to he related to the final result (p>0.05). CS increased from 39% to 61% in patients conservatively treated and from 33% to70% Ln those who were treated with manipulation+arthroscopic capsulectoray. Conclusion; Our study confirms the relationship between frozen shoulder and some metabolism disorders. The level of seropositivity for rheumatoid factor was markedly elevated respect to that registered in general population. However, studied inflammatory and auto-immune parameters did not influence prognosis of AC, even though their level was and remained frequently elevated. After 4 months, shoulder function was better in surgically treated patients.