Description
Introduction: Adhesive capsulitis (AC), also referred to as frozen shoulder, involves progressive thickening and shrinkage of the glenohumeral joint (GHJ) capsule with subsequent pain, stiffness, and limited range of motion (ROM). AC of the GHJ has a prevalence of 2-5% in the general population, with the highest incidence in women aged 40-60 years. The etiology of the disease remains unclear and it is accepted that AC represents the end-stage of an inflammatory process resulting in GHJ capsular contraction typically involving the rotator cuff interval and the containing coracohumeral ligament. The diagnosis is mainly clinical, made on medical history and physical examination. However, especially during the first phase, according to Neviaser’s classification, it could be hard to discern it from other pathologies. Early diagnosis of the disease would undoubtedly help patients and can lead to markedly improve clinical management. Thus, the aim of the present study was to describe a new clinical tool that can quickly lead the orthopaedic surgeons to early diagnosis of AC.
Material and Methods: In this retrospective study, patients referred to Humanitas San Pio X hospital, Milan, Italy, were recruited from March 2023 to May 2023. Patients that complained pain and stiffness of the shoulder were analyzed using the device ShowmotionTM by NCS Lab Srl, Modena, Italy. This instrument analyzed the kinematics of the shoulder using five sensors placed on the upper border of the sternum, on the deltoid insertion on the humerus of the pathological shoulder, on the deltoid insertion of the humerus of the contralateral shoulder and the last two on the mid third of the scapular spine aligned with the upper border of the scapular spine. The Showmotion analysis showed the movement of the scapula (tilt, protraction, retraction, upward, and downward rotation) during every direction of the movement of the glenohumeral joint (abduction, adduction, internal rotation, external rotation, flexion, and extension). This instrument created a graphic to better evaluate the ROM of the scapula of the pathological shoulder (ski blue line) and to compare it with the one of the contralateral shoulder (purple line), moreover it’s possible to compare them with a range of normality preset in the device.
Results: Twenty-four patients (19 females and 5 males, mean age 52±7 years) were included. Showing an early recruitment of the scapular motion in every plane of movements, especially for the superior tilt, the up rotation and the protraction, the Showmotion leaded the orthopaedic surgeons to an early and correct diagnosis
Conclusion: Despite physical examination is a critical component in the diagnosis of the adhesive capsulitis, the Showmotion proved to be a helpful tool in the diagnosis of this pathological conditions, especially for dubious cases.
