The Brisement Procedure for Adhesive Capsulitis
Frozen shoulder syndrome (FSS) is of uncertain etiology. It is characterized by the spontaneous onset of pain in the shoulder, with insidious progressive restriction of both active and passive motion in every direction, mainly external rotation and anterior elevation. Pain is often very severe and disturbs sleep. After several weeks and months, the painful phase gradually abates and is followed by a period of stiffness. This period of stiffness without improvement lasts between 4 and 12 months (1). Spontaneous gradual recovery of motion then follows over a period of several months. The total duration of FSS may be difficult to evaluate because the exact times of onset and resolution are frequently not clear: the initial pain may be confused with that of a shoulder tendonitis or trauma, which, not infrequently, often proceeds to FSS. Complete recovery from FSS is also difficult to define: some patients who consider their range of motion (ROM) still restricted are found to have no restriction on objective testing at longterm follow-up and conversely many other patients who regard their ROM as normal are found to have significant restriction at clinical examination (1-4). Distention arthrography (DA) involves the injection into the joint of contrast media, steroids, lidocaine, and a large volume of fluid in order to obtain joint distension.