Adhesive Capsulitis in a Postmenopausal Woman With Thyroid Dysfunction

Adhesive capsulitis, also known as frozen shoulder, is characterized by progressive pain and loss of shoulder mobility due to capsular inflammation and fibrosis. This is a case of a 50‑year‑old postmenopausal woman with a history of Graves' disease treated by radio‑iodine ablation who presented with a year‑long history of gradually worsening left‑shoulder pain and stiffness. Imaging revealed mild acromioclavicular arthrosis and supraspinatus tendinosis without rotator cuff tear, findings consistent with adhesive capsulitis. Conservative management with physiotherapy, home exercise, and non‑steroidal anti‑inflammatory drugs provided little relief, and a subacromial corticosteroid injection gave temporary improvement. The patient subsequently underwent ultrasound‑guided glenohumeral hydrodistention combined with a suprascapular nerve block and intra‑articular corticosteroid, allowing for immediate pain relief and increased passive range of motion, enabling more effective participation in physical therapy. This case shows how thyroid imbalance and reduced estrogen may jointly contribute to capsular fibrosis and demonstrates that hydrodistention with a nerve block can be used as an effective treatment for adhesive capsulitis refractory to conservative management. Early identification of endocrine and hormonal risk factors may facilitate timely intervention and improve outcomes for patients with frozen shoulder.