Adhesive capsulitis — SCE Rheumatology MCQ

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HardOsteoarthritis and Soft Tissue RheumatologyAdhesive capsulitisSCE Rheumatology

A 52-year-old woman with type 2 diabetes has 5 months of shoulder pain and progressive stiffness. Active and passive external rotation are markedly restricted. Shoulder radiograph is normal. CRP is normal and there is no weakness. What is the most likely diagnosis?

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Correct answer: A — Adhesive capsulitis

The best answer is “Adhesive capsulitis”. Adhesive capsulitis is best because loss of both active and passive external rotation with normal radiograph suggests adhesive capsulitis. septic arthritis is acute with systemic inflammation; rotator cuff tear usually preserves passive movement; PMR is bilateral with raised inflammatory markers; thoracic outlet syndrome causes neurovascular symptoms. Clinical pearl: diabetes is a common association with frozen shoulder. The competing options represent related diagnoses, tests or treatments, but they do not match the decisive phenotype, safety constraint or management point in this stem.

Reference: NICE CKS frozen shoulder: https://cks.nice.org.uk/topics/shoulder-pain/