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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Signs and symptoms of adhesive capsulitis include shoulder pain and limited range of motion. It may become impossible to make simple arm movements. The pain is usually dull or aching, and can worsen at night or with arm motions. There are three (and sometimes four) stages: Prodromal (sharp pain), freezing (chronic pain and loss of motion), frozen (adhesive), and thawing (recovery). There are three phases of skin changes with sclerodactyly: Edematous, indurative, and atrophic. It begins with puffy edema, morning stiffness, or arthralgias. Then there is skin thickening, pruritus, shiny and tight skin, loss of creases, and erythema. Late in the disease course, the skin becomes fragile and lax. The hand may assume a claw-like appearance.
Forefoot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Deformities can be either in the sagittal plane (claw/hammer/mallet toe) or in the axial plane (crossover toe) (Table 6.2). The deformities are initially flexible, but over time, the capsule, collateral ligaments and tendons tighten to render the deformity to become fixed. Nonoperative management measures include toe sleeves, padding over the PIP joint and under the MTP joint. Steroid injections can be used for MTP joint capsulitis.
Surgery of the Shoulder
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Nick Aresti, Omar Haddo, Mark Falworth
Adhesive capsulitis is a common and debilitating pathology. Lots of interest has developed as to the merits of surgical release rather than physiotherapy and hydrodilation alone. While it is generally a self-limiting pathology, the desire to return to function faster with an increased residual range of movement is a relative indication. Care should be taken to rule out the other two main causes of a lack of external glenohumeral rotation: shoulder osteoarthritis and a locked posterior dislocation.
Defining subgroups of patients with a stiff and painful shoulder: an analytical model using cluster analysis
Published in Disability and Rehabilitation, 2021
There are different “stages” of adhesive capsulitis and these stages may have substantial variation in the amount of pain, strength, and the degree of available movement seen on physical examination. No statistically significant differences between clusters were found in the current study for length of symptoms, although the HSM cluster was characterized by patients with a longer duration of symptoms (mean of 8.13 months) than the UWI cluster (mean of 4.33 months). It may be possible that patients falling into these two clusters were simply patients at different stages of the disease, which could certainly influence strength and mobility. Winters et al. [11] found significant differences between the percentage of patients with persistent symptoms between clusters, although their reporting of percentages of patients with persistent symptoms rather than the actual length of symptoms made further comparisons with this study difficult.
Treatment of shoulder pathologies based on irritability: a case series
Published in Physiotherapy Theory and Practice, 2020
Kristin Somerville, Zachary Walston, Tye Marr, Dale Yake
In 2013, the American Physical Therapy Association released the clinical practice guidelines for adhesive capsulitis. Moderate level evidence revealed the use of patient education and stretching. It includes determining the intensity of the stretching exercises and providing education regarding activity modification based on the patient’s tissue irritability level (Kelley et al., 2013). These recommendations coincide with the irritability recommendations presented by McClure and Michener (2015) with their staged approach. It implies the use of identified impairments with tissue irritability as the preferred guide treatment. Overall, literature reveals inconsistencies in assigning diagnostic labels, and the label does not appear to affect selection of interventions (Miller-Spoto and Gombatto, 2014).
Upper extremity impairments in type 1 diabetes with long duration; common problems with great impact on daily life
Published in Disability and Rehabilitation, 2019
Kerstin Gutefeldt, Christina A. Hedman, Ingrid S. M. Thyberg, Margareta Bachrach-Lindström, Hans J. Arnqvist, Anna Spångeus
Facing the limitations of using self-reported symptoms and difficulties in getting specific diagnoses from these, we tried to make a proxy variable (shoulder impairment) for frozen shoulder (adhesive capsulitis) by combining shoulder pain and stiffness [2,3,21]. The shoulder impairment variable was reported in 38% of the patients. This finding is consistent with the recently published report on musculoskeletal complications in the DCCT/EDIC cohort with patients’ characteristics similar to the present study, i.e., a mean age of 52.2 ± 6.9 years vs. 50.3 ± 9.6 years and diabetes duration of 31.1 ± 4.9 years vs. 35.1 ± 9.5 years [1], where adhesive capsulitis was found in 31% of the patients. In other reports on younger patients with type 1 diabetes with a duration of about 20 years, the prevalence of adhesive capsulitis was 10–16% [2,11,21]. Shoulder pain is common in the general population with a reported prevalence of 7–27% [22], while the prevalence of adhesive capsulitis has been estimated to be 2–5% [3,22]. In our study, shoulder impairment, as suggestive of adhesive capsulitis, had a prevalence as high as 18% in the control group why it is conceivable that the questions we used for this condition is somewhat unspecific, but nevertheless highlights a high prevalence of shoulder impairments in patients, in part explained by frozen shoulder, and that these impairments were more prevalent in patients with diabetes than in controls.