American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is indicated by decreased range of motion and pain with shoulder movement in all directions?

1. Rotator cuff tear

2. Adhesive capsulitis

3. Shoulder impingement syndrome

4. Acromioclavicular joint injury

The correct answer is: Adhesive capsulitis

Decreased range of motion and pain with shoulder movement in all directions is characteristic of adhesive capsulitis, commonly known as frozen shoulder. This condition involves inflammation and thickening of the shoulder joint capsule, restricting movement. Patients with adhesive capsulitis typically experience significant stiffness and pain not only when actively trying to move the shoulder but also in passive movements. In contrast, a rotator cuff tear usually results in pain and weakness, especially when lifting the arm or reaching overhead, with a more limited pain range rather than overall restriction in all planes of motion. Shoulder impingement syndrome would generally cause pain primarily during specific movements, rather than a consistent loss of motion in all directions. An acromioclavicular joint injury tends to manifest with localized pain at the top of the shoulder, particularly with movements that involve elevation or cross-body motion. Thus, adhesive capsulitis accurately describes the presentation of global shoulder motion restriction and pain experienced by the patient.