In the painful stage, such hypoechoic material may demonstrate increased vascularity with Doppler ultrasound.Grey-scale ultrasound can play a key role in timely diagnosis of adhesive capsulitis due to its high sensitivity and specificity. It is also widely available, convenient, and cost efficient. Thickening in the coracohumeral ligament, inferior capsule/ axillary recess capsule, and rotator interval abnormality, as well as restriction in range of motion in the shoulder can be detected using ultrasound. The range of motion is prohibited due to scapulohumeral rhythm changes occurring in the shoulder joint. The altered scapular kinematics can restrict anterior and posterior tilting, downward rotation and depression as well as external rotation. All of these restrictions lead the scapula to be excessively upwardly rotated. The restriction of the scapular posterior tilt is due to tightness in the lower serratus anterior, anterior capsule and the pectoralis minor. Downward rotation and depression are restricted due to the tightness of the rhomboids, upper trapezius and the superior capsule. Respective sensitivity values were 64.4, 82.1, 82.6, and 94.3, and respective specificity levels were 88.9, 95.7, 93.9, and 90.9. Management
Management of this disorder focuses on restoring joint movement and reducing shoulder pain, involving medications, occupational therapy, physical therapy, or surgery. Treatment may continue for months; there is no strong evidence to favor any particular approach. The main treatment for adhesive capsulitis is a trial of conservative therapies, including analgesia, exercise, physiotherapy, oral nonsteroidal anti-inflammation drugs, and intra-articular corticosteroid injections.Medications such as NSAIDs can be used for pain control.
Abrocitinib, sold under the brand name Cibinqo, is a Janus kinase inhibitor medication used for the treatment of atopic dermatitis (eczema). It was developed by Pfizer. Medical uses
Abrocitinib is indicated for the treatment of moderate-to-severe atopic dermatitis in adults who are candidates for systemic therapy. Side effects
The most common adverse effects in studies were upper respiratory tract infection, headache, nausea, and diarrhea. Pharmacology
Mechanism of action
It is a selective inhibitor of the enzyme janus kinase 1 (JAK1). Pharmacokinetics
Abrocitinib is quickly absorbed from the gut and generally reaches highest blood plasma concentrations within one hour. Only 1.0 to 4.4% of the dose are found unmetabolized in the urine. History
April 2016: initiation of Phase 2b trial
December 2017: initiation of JADE Mono-1 Phase 3 trial
May 2018: Results of Phase 2b trial posted
October 2019: Results of Phase 3 trial presented
June 2020: Results of second Phase 3 trial published

Society and culture
Legal status
In October 2021, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Cibinqo, intended for the treatment of atopic dermatitis. The applicant for this medicinal product is Pfizer Europe MA EEIG. In December 2021, the European Commission approved abrocitinib for the treatment of atopic dermatitis.In January 2022, the United States Food and Drug Administration (FDA) approved abrocitinib for adults with moderate-to-severe atopic dermatitis. References
External links
"Abrocitinib". Drug Information Portal. U.S. National Library of Medicine.