title: Adhesive Capsulitis in Eight Dogs: Diagnosis and Management.
abstract: OBJECTIVE
  To describe clinical and diagnostic findings as well as management of adhesive capsulitis in dogs.
  
  
  BACKGROUND
  Adhesive capsulitis, also known as frozen shoulder, is a syndrome defined by loss of range of motion of the shoulder and may be the end-stage manifestation of several primary conditions.
  This is a case series report of eight dogs with chronic forelimb lameness diagnosed with adhesive capsulitis.
  
  
  METHODS
  Medical records (June 1, 2010-September 1, 2015) including, physical examination findings, radiographic findings, magnetic resonance imaging (MRI) findings, arthroscopy findings, and treatment plans were reviewed.
  
  
  RESULTS
  All dogs presented with a chronic, grade III-VI/VI forelimb lameness. On orthopedic examination, all dogs had moderate to significant discomfort on shoulder extension and flexion and severe restriction of range of motion. Six of the eight dogs had evidence of bone remodeling and sclerosis in the affected shoulder on radiographs. Six of the dogs had an initial diagnostic ultrasound performed, which revealed evidence of fibrous scar tissue. Five dogs had MRI performed that revealed moderate shoulder effusion and enhancement of the synovial lining of the shoulder. Arthroscopy was performed in five of the eight patients. Three were noted to have significant contracture, adhesions, and fibrous scar tissue of the joint capsule. Severe inflammation was noted throughout the synovium of two patients. All eight patients tried conservative management consisting of oral medications and rehabilitation therapy. Five of the eight patients received extracorporeal shockwave therapy. Three patients received regenerative medicine treatment in the affected supraspinatus and shoulder. Regardless of the treatment elected, none of the dogs were reported to have significant improvement.
  
  
  CONCLUSIONS
  Adhesive capsulitis is an uncommon cause of chronic forelimb lameness. Further investigation is needed to describe the etiology and pathogenesis of adhesive capsulitis in dogs to evaluate the effectiveness of both non-surgical and surgical treatment modalities, establish treatment protocols, and evaluate short- and long-term clinical outcome of patients.
  
  
  CONCLUSIONS
  Adhesive capsulitis should be considered in patients with chronic forelimb lameness and moderate to significant discomfort and restriction on shoulder range of motion.
authors.affiliation: Veterinary Orthopedic and Sports Medicine , Annapolis Junction, MD , USA.
authors.forename: Brittany J
authors.initials: BJ
authors.lastname: Carr
authors.affiliation: Veterinary Orthopedic and Sports Medicine , Annapolis Junction, MD , USA.
authors.forename: Sherman O
authors.initials: SO
authors.lastname: Canapp
authors.affiliation: Veterinary Orthopedic and Sports Medicine , Annapolis Junction, MD , USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Canapp
authors.affiliation: Veterinary Orthopedic and Sports Medicine , Annapolis Junction, MD , USA.
authors.forename: Lauri-Jo
authors.initials: LJ
authors.lastname: Gamble
authors.affiliation: Veterinary Orthopedic and Sports Medicine , Annapolis Junction, MD , USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Dycus
keywords: adhesive capsulitis; fibrous scar tissue; forelimb lameness; frozen shoulder; range of motion; synovitis