Frozen Shoulder (Adhesive Capsulitis)

Adhesive capsulitis: idiopathic painful loss of shoulder mobility. Most common 40–60y, F>M, association with diabetes (5×), thyroid disease, Dupuytren's, prior surgery. Three phases (overlapping): • Freezing (2–9 months): increasing pain, especially at night; gradual ↓ ROM. • Frozen (4–12 months): reduced pain but stiff shoulder; significant functional impairment. • Thawing (5–24 months): gradual improvement of ROM + function. Total duration 1–3 years. Diagnosis clinical: • Painful restriction of active + passive ROM in all directions. • External rotation most limited. • XR: normal (excludes arthritis). • MRI / USS: thickened capsule + axillary recess obliteration. Differentials: rotator cuff pathology, OA, calcific tendinopathy, septic arthritis, malignancy.