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Adhesive Capsulitis — SCE Rheumatology MCQ

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EasySoft Tissue RheumatologyAdhesive CapsulitisSCE Rheumatology

A 55-year-old woman reports progressive pain and stiffness of her right shoulder over 3 months following a minor fall. Examination shows global restriction of both active and passive glenohumeral movement, with external rotation particularly restricted. Shoulder radiographs are normal. What is the most likely diagnosis?

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Correct answer: E — Adhesive capsulitis

The diagnosis is adhesive capsulitis (frozen shoulder), which produces progressive global restriction of both active and passive glenohumeral movement. Passive external rotation is characteristically especially restricted, and radiographs are usually normal because the disorder affects the joint capsule rather than bone. A minor injury or subsequent reduced shoulder use can precede secondary adhesive capsulitis. Rotator cuff tears and subacromial impingement primarily impair painful active movement, with passive range relatively preserved. Glenohumeral osteoarthritis can restrict active and passive movement but should usually produce radiographic degenerative changes. Acromioclavicular osteoarthritis causes localised superior shoulder pain and pain on cross-body adduction rather than a global capsular restriction.

Reference: Whittington Health NHS Trust. Frozen Shoulder, sections 'Frozen shoulder symptoms' and 'What else could frozen shoulder be?', updated 24 April 2025. https://www.whittington.nhs.uk/default.asp?c=47249