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Adhesive capsulitis

Last reviewed: 30 Oct 2023
Last updated: 24 Feb 2023



History and exam

Key diagnostic factors

  • shoulder stiffness
  • decreased shoulder active range of motion
  • decreased shoulder passive range of motion
  • positive coracoid pain test
  • positive shoulder shrug test
More key diagnostic factors

Other diagnostic factors

  • shoulder pain
  • alternative diagnosis not suggested by provocative maneuvers
  • negative Spurling maneuver (to exclude cervical spine radiculopathy)
  • negative Hawkins test (to exclude rotator cuff impingement)
  • negative Neer test (to exclude shoulder impingement)
  • negative Speed test (to exclude superior labrum from anterior to posterior [SLAP] tear)
  • negative O'Brien test (to exclude superior labrum from anterior to posterior [SLAP] lesion)
  • negative Yergason test (to exclude proximal biceps tendon pathology)
  • negative apprehension test (to exclude anterior shoulder instability)
  • negative relocation test (to further exclude anterior shoulder instability)
  • negative Kim test (to exclude posteroinferior labral lesion of the shoulder)
Other diagnostic factors

Risk factors

  • age 40 to 70 years
  • diabetes mellitus
  • prior history of adhesive capsulitis
  • shoulder pain and immobilization
  • previous shoulder surgery
  • female sex
  • thyroid disease
More risk factors

Diagnostic investigations

1st investigations to order

  • plain film radiographs
  • ultrasound
More 1st investigations to order

Investigations to consider

  • MRI/MR arthrogram shoulder
  • CT arthrogram
More investigations to consider

Treatment algorithm


all patients



Matthew T. Provencher, MD, CAPT MC USNR
Matthew T. Provencher

Complex Shoulder Knee and Sports Surgery

The Steadman Clinic

Steadman Philippon Research Institute




MTP is a consultant for Arthrex and Joint Restoration Foundation. MTP receives royalties from Arthrex and has received an honorarium from Arthrosurface. He receives research funding from Vail Health and Steadman Philippon Research Institute.

Lance LeClere, MD, LCDR MC USN
Lance LeClere

Staff Surgeon

Team Physician

Orthopaedic Sports Medicine and Shoulder Surgery

Naval Health Clinic

US Naval Academy




LL declares that he has no competing interests.

Jennifer Smith, MD, LCDR MC USN
Jennifer Smith

Staff Surgeon

Orthopaedic Sports Surgery

Naval Medical Center San Diego

San Diego



JS declares that she has no competing interests.

Peer reviewers

Matthew Busam, MD

Orthopedic Surgeon

Cincinnati Sports Medicine Research and Education Foundation




MB declares that he has no competing interests.

Daniel Solomon, MD

Co-Director of Orthopedic Sports and Shoulder Service

Department of Orthopedic Surgery

Naval Medical Center San Diego

San Diego



DS declares that he has no competing interests.

Steven Corbett, BSc, PhD, FRCS (Tr & Orth)

Consultant Orthopaedic Surgeon

Guy's and St Thomas’ Hospital NHS Foundation Trust




SC declares that he has no competing interests.

  • Adhesive capsulitis images
  • Differentials

    • Posterior glenohumeral dislocation
    • Rotator cuff injury
    • Subacromial rotator cuff impingement
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: chronic shoulder pain
    More Guidelines
  • Patient leaflets

    Rotator cuff injury

    More Patient leaflets
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