American Board of Internal Medicine (ABIM) Certification Practice Exam

How is adhesive capsulitis typically treated initially?

1. Physical therapy

2. Glucocorticoid injection

3. Surgery

4. Hot compress therapy

The correct answer is: Glucocorticoid injection

Adhesive capsulitis, commonly known as frozen shoulder, is often characterized by pain and progressive loss of range of motion in the shoulder joint. The initial treatment approach for adhesive capsulitis typically involves non-invasive methods aimed at alleviating symptoms and improving mobility. While glucocorticoid injections (the chosen option) can provide significant anti-inflammatory benefits and pain relief in the early stages of adhesive capsulitis, the most common initial treatment is actually physical therapy. This form of management is designed to improve the range of motion and function through targeted exercises and modalities. However, glucocorticoid injections can be an effective adjunctive treatment to address inflammation and pain, particularly in patients who experience severe discomfort that limits their ability to participate in therapy. Options like surgery and hot compress therapy are generally not considered first-line treatments. Surgery is reserved for cases that do not respond to conservative treatment and may include manipulation under anesthesia or release of the joint capsule. Hot compress therapy, while it may provide temporary relief, does not address the underlying pathology and is not as effective as more structured treatment modalities for improving function in adhesive capsulitis. In summary, while glucocorticoid injections serve an important role in managing symptoms, particularly in conjunction with physical