Adhesive capsulitis, commonly known as frozen shoulder, is a clinical diagnosis characterised by a painful, progressive global loss of both active and passive shoulder motion. In this Orthovellum masterclass, we explore the underlying capsular inflammation that progresses to fibrosis, explaining why loss of passive external rotation is the hallmark sign. ⏱ Chapters 0:00 Intro 0:14 Essentials 0:48 Pathology 1:20 Staging 1:50 Diabetes 2:30 Imaging 3:03 Algorithm 3:37 Pains 4:05 Numbers 4:35 Surgicaltechnique 5:09 Clinical reasoning — Diagnose 5:46 Clinical reasoning — Resistant This comprehensive video covers everything you need to know about adhesive capsulitis, from the initial synovial inflammation and angiogenesis to the dense, disorganised collagen deposition that causes a contracted, low-volume joint. We delve into the three classic clinical stages—freezing, frozenand thawing—and outline the escalating treatment ladder, emphasising why early intra-articular corticosteroid injections are highly effective for pain, while gentle stretching physiotherapy is crucial for recovering stiffness. Understanding this condition is vital, as it is strongly linked to diabetes mellitus and, despite being self-limiting, can take one to three years to fully resolve. 🦴 IN THIS VIDEO YOU'LL LEARN • How to clinically diagnose adhesive capsulitis using the hallmark sign of loss of passive external rotation • The underlying pathophysiology cascade from synovial inflammation to myofibroblast-driven capsular fibrosis • The three classic clinical stages of frozen shoulder: freezing, frozenand thawing • Why diabetes mellitus is the strongest risk factor and how it predicts a more resistant disease course • How to classify frozen shoulder by cause into primary (idiopathic) and secondary (intrinsic, extrinsic, systemic) categories • The role of imaging in excluding secondary causes like osteoarthritis or a locked posterior dislocation rather than making the diagnosis • How to apply an escalating treatment ladder matched to the specific stage of the disease • Why forced stretching is counterproductive and how needle hydrodilatation fits into the management pathway • The surgical indications for manipulation under anaesthesia or arthroscopic capsular release in refractory cases ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Frozen shoulder is a strictly clinical diagnosis; radiographs are usually normal and used primarily to exclude other pathologies. ✔️ Loss of passive external rotation with the arm at the side is the signature discriminating clinical sign. ✔️ Diabetes mellitus is the strongest risk factor, often resulting in bilateral, treatment-resistant disease. ✔️ An intra-articular corticosteroid injection provides the greatest benefit during the painful, inflammatory freezing stage. ✔️ Most cases are self-limiting over a one to three-year period, but recovery is significantly prolonged. ✔️ Forced stretching is counterproductive against an actively contracting, fibrotic capsule. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, medical studentsand clinicians seeking a comprehensive understanding of shoulder pathology. Curious patients suffering from shoulder stiffness will also find valuable insights into the condition's natural history and treatment. 📚 RELATED TOPICS: Rotator interval anatomy and coracohumeral ligament function · Glenohumeral osteoarthritis versus adhesive capsulitis · Myofibroblast pathology in Dupuytren disease · Technique for shoulder intra-articular corticosteroid injections · Arthroscopic capsular release surgical technique · Secondary stiff shoulder following trauma or immobilisation 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #adhesivecapsulitis #frozenshoulder #shoulderpain #orthovellum #shoulderinstability #medicalstudent #orthopedicsurgery #shoulderstiffness #diabetes #sportsmedicine #capsularrelease