Background: Frozen shoulder (FS), also known as adhesive capsulitis (AC), is a painful disorder of the shoulder joint characterized by gradual onset and progressive restriction of both active and passive shoulder movements. AIM: To evaluate the efficacy, advantages, and disadvantages of intra-articular steroid injection in idiopathic frozen shoulder unresponsive to NSAIDs, using VAS, SPADI, and Oxford Shoulder Score for outcome assessment. Methodology: This prospective study was conducted on the Indian population using radiographic tools at the Orthopedic and Physiotherapy Departments of Medical College and Associated Group of Hospitals, Kota, from November 2022 to January 2024. Result: In this study of 45 patients with idiopathic frozen shoulder, most were middle-aged housewives with the dominant arm affected, presenting mainly with shoulder pain. Corticosteroid injection with physiotherapy produced significant, consistent improvement in pain, function, and range of motion over 12 weeks, confirming its short-term efficacy. Conclusion: Corticosteroid injections are effective for short-term pain relief and functional improvement in adhesive capsulitis, especially when combined with physiotherapy in the early disease stages.

Background: Rheumatoid arthritis (RA) is a persistent inflammatory condition linked to heightened cardiovascular morbidity and mortality. Cardiac autonomic dysfunction may elevate cardiovascular risk but is still inadequately investigated in RA patients. Methodology: This case-control study comprised 80 RA patients diagnosed by ACR/EULAR 2010 criteria and 80 age- and sex-matched healthy controls. The evaluation of cardiac autonomic function was conducted using 24-hour Holter monitoring and heart rate variability analysis. Time-domain parameters (SDNN, RMSSD, pNN50) and frequency-domain parameters (LF, HF, LF/HF ratio) were assessed. The DAS28-ESR score was utilized to evaluate disease activity. The statistical analysis comprised independent t-tests and Pearson correlation coefficients. Results: Patients with RA exhibited markedly reduced heart rate variability measures in comparison to the control group. In rheumatoid arthritis (RA) patients, SDNN measured 98.4 ± 24.6 ms, compared to 142.3 ± 28.4 ms in the control group (p < 0.001). RMSSD measured 24.8 ± 8.2 ms compared to 38.6 ± 10.4 ms (p < 0.001). The LF/HF ratio was markedly increased in RA patients (2.8 ± 0.9 compared to 1.6 ± 0.5, p < 0.001), signifying sympathetic dominance. Cardiac autonomic dysfunction exhibited a strong correlation with disease duration (r = -0.52, p < 0.001) and DAS28-ESR score (r = -0.48, p < 0.001). The prevalence of autonomic dysfunction was 62.5% in RA patients compared to 18.8% in the control group (p < 0.001). Conclusion: Patients with RA demonstrate considerable cardiac autonomic dysfunction, marked by diminished heart rate variability and sympathovagal imbalance. The activity and length of illness are critical factors influencing autonomic dysfunction, indicating the necessity for early cardiovascular risk evaluation in the management of RA.