Margit Kooijman

46 Vignette 3: Early presentation of adhesive capsulitis Around 80% of general practitioners would prescribe the patient NSAIDs or administer a glucocorticoid injection (table 4). Also a large group of physiotherapists (47%) would refer the patient to their general practitioner for pain medication. Many general practitioners (61%), next to taking care of pain relief would refer the patient for some type of physiotherapy treatment, mainly with the intention of exercise therapy. Most physiotherapists would start treatment and considered exercise therapy and mobilization of equal importance. Significantly more physiotherapists than general practitioners indicated they would give advice on home exercises and activity or work modification. Also significantly more physiotherapists than general practitioners chose to perform a psychosocial evaluation, but in both groups it involved only a small percentage of patients. Contrary to the other vignettes, they differed significantly on their prognosis; more general practitioners expected a recovery within two or six weeks. TABLE 4. Management of early presentation of adhesive capsulitis * V3 General practitioners (n = 84) Physiotherapists (n = 110) P-value N (%) N (%) Investigations Would not order any tests 62 (76) na X-ray 12 (15) na Ultrasound primary care 10 (12) na Ultrasound secondary care 2 (2) na CT scan 0 (0) na MRI scan 0 (0) na Blood tests (e.g. FBE, ESR) 7 (9) na Consultation management/advice Expectant observation only 4 (5) 9 (8) 0.333 Advice on home exercise 37 (45) 80 (75) ˂ 0.001 ** Activity/work modification 26 (32) 74 (70) ˂ 0.001 ** Psychosocial evaluation 3 (4) 26 (25) ˂ 0.001 ** Mobilisation na 68 (64) Massage na 23 (22) Exercise therapy na 67 (63) Prescribe medication: Over-the-counter- analgesics 11 (13) na Prescription analgesics 15 (18) na Prescription NSAIDs 61 (74) na Administer a glucocorticoid injection: 49 (58) na