Which feature is most characteristic of adhesive capsulitis (frozen shoulder)?

Which feature is most characteristic of adhesive capsulitis (frozen shoulder)?

• A. Restriction of both active and passive range of motion in the shoulder without an intrinsic shoulder disorder.
• B. Severe joint swelling and fever.
• C. Pain that is present only during overhead activities with preserved rotation.
• D. Painful arc with preserved ability to touch the back.

Answer: (A)

Adhesive capsulitis presents with a global loss of shoulder motion due to tightening and thickening of the joint capsule. The key feature is that both active (what the patient can move) and passive (what the examiner can move) range of motion are restricted. This reflects a structural contracture inside the glenohumeral joint itself, not just pain with use or weakness of a particular muscle. That’s why the best description is restriction of both active and passive range of motion without an intrinsic shoulder disorder. Other patterns—severe swelling and fever suggesting infection, pain only with overhead activities with preserved rotation suggesting rotator cuff pathology or impingement, or a painful arc with the ability to touch the back suggesting impingement—do not fit the global, intrinsic ROM limitation seen in frozen shoulder.

Adhesive capsulitis presents with a global loss of shoulder motion due to tightening and thickening of the joint capsule. The key feature is that both active (what the patient can move) and passive (what the examiner can move) range of motion are restricted. This reflects a structural contracture inside the glenohumeral joint itself, not just pain with use or weakness of a particular muscle.

That’s why the best description is restriction of both active and passive range of motion without an intrinsic shoulder disorder. Other patterns—severe swelling and fever suggesting infection, pain only with overhead activities with preserved rotation suggesting rotator cuff pathology or impingement, or a painful arc with the ability to touch the back suggesting impingement—do not fit the global, intrinsic ROM limitation seen in frozen shoulder.