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Adhesive Capsulitis — SCE Rheumatology MCQ

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EasySoft Tissue RheumatologyAdhesive CapsulitisSCE Rheumatology

A 55-year-old man has a 4-month history of gradually progressive, atraumatic shoulder pain and stiffness. Which examination finding most strongly supports adhesive capsulitis rather than rotator cuff disease?

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Correct answer: B — Global restriction of active and passive movement, especially external rotation

Adhesive capsulitis causes a capsular restriction of glenohumeral movement affecting both active and passive range, with external rotation typically the most restricted movement. This contrasts with uncomplicated rotator cuff disease, in which pain or weakness may markedly reduce active movement while passive range remains relatively preserved. A painful arc and resisted external-rotation weakness support rotator cuff-related pathology, making C and D inappropriate; A describes the same active–passive discrepancy. Focal bicipital-groove tenderness with pain on resisted elbow flexion suggests long-head biceps pathology rather than capsular contracture. Glenohumeral osteoarthritis can also restrict passive movement, so radiography may be needed if clinical features suggest arthritis, but it does not make another option defensible in the stated comparison.

Reference: NHS Greater Glasgow and Clyde, Right Decisions, Contracted shoulder—Clinical testing section, accessed 2026: https://www.rightdecisions.scot.nhs.uk/ggc-msk-index/shoulder/contracted-shoulder/